How do people avoid burnout?
March 27, 2016 1:54 PM   Subscribe

I love my clients, I love my coworkers, I love the work I do, but although there are many wonderful moments of connection and times when I get to see my clients succeed, overall my work is unrelentingly enraging and grim. I want to keep doing this kind of work, but after less than two years, I already end most days feeling depleted, angry, and hopeless. Social service/healthcare/helper colleagues, how do you keep going?

I don't know if there's much to add here, I think you probably get the point. But to belabor it a little, I work with homeless people in a region with especially pronounced economic inequality. I daily see the impact of the previous few generations of racist social and economic policy are paying out in my clients literally dying on the streets while I have an extremely limited ability to intervene.

Just being kind and empathetic goes a long way for folks who are used to being treated terribly, but I am spending each day listening to and being present for the unremitting physical and spiritual suffering of my clients. I can't imagine more meaningful, or more draining work.

I exercise several times a week (working toward more but time is limited). I mediate a little (just 5 minutes at the beginning of each work day is all I have squeezed in so far). I find myself exploring philosophy and critical theory to try to provide meaning to to all this, but I am, probably futilely, searching for any and all suggestions to make this a sustainable career, ideally through the next decade.

If you've been working around trauma and/or oppressive circumstances and/or human suffering for a long time, what do you do to sustain yourself, and keep yourself present when at work?

All ideas welcome.
posted by latkes to Religion & Philosophy (22 answers total) 21 users marked this as a favorite
 
My Spirituality is a huge part of the reason I do not go insane.

I also work very hard on enjoying what I have, and I do spend lots if time resting, making sure I get good sleep, and doing things I enjoy.

I also use accrewed time liberally. Because I need it.
posted by AlexiaSky at 1:59 PM on March 27, 2016 [2 favorites]


And therapy, because I need space for myself.
posted by AlexiaSky at 2:00 PM on March 27, 2016 [2 favorites]


Best answer: Not my field, I can't do it. I've done similar in the past, but never again.

The people who are able to do it long term have a couple of coping strategies that seem to help:

1. Try not to socialize with co-workers very much. If you do, try to avoid talking about your work.

2. Have a mentor to whom you can talk. Venting some, but mostly about you and how you're coping. Someone who functions as a check on your sanity. You might have to pay for this from a professional, but usually not, if you network well with people who are in professional positions tangential to your own.

3. Have a trusted partner/friend to whom you can talk in a completely off-the-record way. Almost entirely as a pressure relief valve (venting). This is someone you can actually go "OMG, this client is so fucked up," and so on. Someone you can engage in dark humor with. Your fiend isn't there to fix problems, but to let you work out whatever you need to, however you need to, even if it goes way into territory you'd never want a professional peer to see/hear.
posted by yesster at 2:19 PM on March 27, 2016 [2 favorites]


Oh, and:

4. Develop engaging activities/hobbies that are completely unrelated to your work.


Good luck! Thank you for doing what you do!
posted by yesster at 2:26 PM on March 27, 2016 [2 favorites]


Best answer: Yes. You should have at least three or four weeks of vacation each year. Everyone like to say "oh this is impossible, this can't happen." Why? Because everyone says so. The system is bad.

Also it's a good point that the process is part of your work. Which means, your mentorship and supervision and strategy and mental health stuff are part of your work day. Grabbing a few minutes to meditate in the morning isn't fair. Beginning your work day with 20 minutes of quiet time is more like it. Making space for this feels bad and wrong and might even meet resistance from others. But you should model this kind of care for others, they'll come to agree.
posted by RJ Reynolds at 2:27 PM on March 27, 2016 [2 favorites]


Not just an engaging hobby, but a community of people you can share the hobby with.
posted by A hidden well at 2:39 PM on March 27, 2016 [1 favorite]


A lot of people who work in environments like this in medicine (especially in critical care) manage this issue by diversifying their work tasks. For example, one of my mentors spends about 25% of her time actually providing care in the ICU, 25% teaching, and 50% doing research. She's told me on numerous occasions that she doesn't believe she has the emotional resilience to work in the ICU all the time, and about one week per month is the "sweet spot" for her that is challenging and rewarding but not perpetually draining.

While there are definitely good coping methods out there, there's something to be said for identifying your actual capacity for doing this job -- each person is different and it's not a failure if working full time the way you do now and maintaining your emotional health are mutually exclusive.
posted by telegraph at 2:43 PM on March 27, 2016 [3 favorites]


I do alot of cleansing meditations, imagining the stress from my day floating away and warm happy feelings in. I do this all the time I add in progressive muscle relaxation .

I absolutely allow myself time to aknowledge how fucked up the world is. I'm a talker and I debrief with coworkers when something bad happens.

Home is home and work is work. If I talk about work outside of work it is only about rediculous things, not about trauma things.
posted by AlexiaSky at 3:28 PM on March 27, 2016 [2 favorites]


Working in the poorest Title 1 schools is like this. My coworkers and I couldn't live without summers off. People who teach summer school get catastrophically burnt out. My suggestion? Switch to teaching in high poverty schools. You'll work just as hard, make just as much of an impact, get paid just as terribly, but you'll get summers off.

For those doing the math in their heads and concluding that teachers are overpaid, consider: Summer is 10 weeks long. Only two weeks are paid. Basically, teachers are seasonal employees. Also, since teachers work hundreds of hours for free during the school year, paid summers off would be only fair. Finally, even though you technically don't get paid for summer, you can have the district withhold a portion of your paycheck every two weeks, to be disbursed over the summer, so it feels like you get paid over the summer. It's better than teaching summer school, or getting a seasonal job like a lot of teachers do.

Think about it.
posted by toodleydoodley at 3:39 PM on March 27, 2016 [4 favorites]


10+ years in social services/non-profit/A&D here. My husband retired from a related field and more or less knows my client base. He is a fantastic sounding board. So yes you need someone to whom you can vent who is sympathetic or at least understands gallows humor. It's not lack of compassion - it's a survival technique. And accept that it's okay to rant about clients/co-workers/agency/the world at large. You're not being an asshole. It's just a way to vent frustration. It's a way to keep a healthy emotional distance. You can't be emotionally tied to every client. It's just not sustainable.

Take care of yourself first. The first rule of EMS is BSI/Scene Safety for a reason: you can't help if you become another patient and that applies to any kind of social work. So make sure you are taking your allotted time. Take your lunch away from your office. Take all your vacation time. Insist upon it. Don't fall into the trap of "but I'm essential!" or "Client Bob needs me" or your supervisor saying "Soon, I promise you'll get a vacation soon." I mean really if you got hit by a bus tomorrow, your agency would find a way to cope. So you must put your self care first. Make sure there is someone to take care of you - even if it's a friend coming over to make you lunch once in a while or getting a massage or splurging on a good haircut. Just the act of someone caring for you means you can turn off for a little bit. It's not selfish. It's someone helping you so you can help others.

I read an article a while ago pushing back against the idea that women should exercise more/eat better/whatever so they can do more for other people. They argued that women should do things for themselves not just so they can take even more care of others. I thought that was really insightful. So regardless if you are a man or a woman, spoil yourself sometimes. Make it about yourself not about a way to do even more for other people.

My coworkers and I mostly see people near the bottom and most of them don't have any interest in getting better. Even seeing one person get and stay clean and sober is rare in my agency. The best we can get is people clean and sober for a short period of time. A police officer I worked with years ago told me that it's hard dealing with the same people over and over, the same kids getting into trouble, the same DV calls to the same address every week, the same addicts on the same street corners, but it would be a shame if someone finally wanted help and there was no one there. So that's what he did - he was there when people got to the point of asking for help. That's kept me going. I think I come across as pretty cranky and cynical and I won't work harder than the clients at getting sober but if they ever do ask for help, I'm on it.

Lastly, maybe understand that direct service isn't possible to do your whole career. After a decade, I'm in school to move on to a new career. I've done as much as I can do and I'm don't really believe in our mission statement anymore. And that's not fair to the clients or the agency. So look ahead and think of some alternate plans. What can you move towards in the long run that will allow you to contribute but not necessarily be on the front lines?

Good luck and thanks for all you do!
posted by Beti at 3:40 PM on March 27, 2016 [5 favorites]


A friend in a similar job told me she takes a very long shower as soon as she gets home, it's her ritual for leaving work behind.
posted by mareli at 4:00 PM on March 27, 2016 [1 favorite]


Best answer: Managing my expectations. I know that my clients are not going to get sober, housed, and psychologically stable in a week. Or a month. Or a year. Quite possibly not in ten years. I need to have realistic expectations of my client's situation and the bureaucratic situation in which I work, so that I'm not constantly beating my head against a wall.

Not being a white knight. "Don't work harder than your clients" can be a good guiding principle, assuming you're using it compassionately to help remind you to work at your client's pace (and not dismissively, as I've heard some people use it, to justify not doing their job). I also think it's important to work with as many partnering agencies or providers as you can, to help you feel like you're part of a team and not the sole person who can help any given client, and to hook clients into networks of support (family, friends, support groups, other agencies, helplines, peer support, etc). If you believe you are the only person who can help any given client, (a) you're wrong, (b) you need to work with that client to fix that, by linking them with other resources, and (c) you're headed quickly to burnout. The "It's all on me!" feeling is, in my experience, the #1 cause of people in caring professions burning out. (It's also often paternalistic, which keeps clients in a passive/victim role, which tends to either feed client dependency or encourage clients to rebel against the idea that they're helpless. Both of which create more work for the professional and worse outcomes for the client.) I find that I'm more likely to start feeling burnt out even being around other professionals who think that way and frame their client interactions that way. It's a bad road to go down, no matter how compassionate the initial urge.

Recognizing that I am experiencing vicarious trauma through pretty much each of my clients, and managing my self-care appropriately. Not beating myself up for feeling drained. Setting firm work-life boundaries so that I get enough downtime. Doing the things that make me feel better if I don't always want to do them (getting enough sleep, exercising) and not just the things that feel good in the moment but don't make me feel better long-term (watching excessive amounts of tv, drinking excessively). Forgiving myself when I do those things anyway. Showing a compassionate wisdom to myself that recognizes that doing those things is human and normal, which helps me show a compassionate wisdom to my clients when they're experiencing relapses or making unhelpful choices.

Staying organized at work. Knowing that I can pick up tomorrow where I left off today means that I don't have to keep a running list in my head all evening of all the things I have to do tomorrow. I have multiple hanging files for my various "To Do" papers, I keep my calendar accurate and updated and put future commitments on there with all the info I need (phone numbers, addresses, etc.). It also keeps me from rushing around in an anxious panic during the work day, which helps keep my adrenaline down overall.

I don't do them as much anymore, but symbolic rituals to end the work day helped enormously in my first few years. I generally ended each day (sometimes after each client appointment each day) by slowly and meditatively washing my hands and saying to myself, "I did what I could do for that client today, so I am clearing any responsibilities to that person for now." Leave work at work, and end the work day at a reasonable hour.
posted by lazuli at 5:26 PM on March 27, 2016 [12 favorites]


I feel lucky that I knew several people in my field before I started, and they really hammered into/demonstrated to me the importance of putting my own oxygen mask first before helping others. I'm a newbie, so I'm sure this will change over time, but for now:

Firm boundaries - There are just some things I won't get involved in, and although at first I felt bad, ashamed, or selfish to draw that line, it's a huge help to not get too drawn in emotionally. I also do absolutely no work-related activities once I leave the office.

Celebrating the smallest victories - it's difficult to see the same clients struggle with the same difficulties again and again. I just remind myself to stay in the present, where the client is now, and give recognition to whatever step they've taken that day. While the big picture is important, it can be overwhelming.

Rituals - for particularly heavy days, I will go home, write down what I heard, then burn the paper I wrote it on. Otherwise, I go for a run with my dog or take her to the dog park after work...seeing her be happy happy happy is contagious and healing. Having regularly scheduled activities like group trivia or yoga in the park is a must for me.

Support - therapy on the regular, and having someone to talk to about it. I have a partner who I can just say "today was shitty b/c of x, y, z", and they respond "oh god, that is really shitty", gives me a hug, and then we move on. In the past I've had partners who've tried to "fix it" or try to tell me how I should feel about something, and that is no good for me.

Good work environment - Somehow I lucked into a group of coworkers/supervisors who are amazing. They basically give any staff member the green light if you need to take time off, whether that be a day or a few weeks. The culture is such that even the bigwig supervisors share when they are overwhelmed, and need a break, and that has set a good example for everyone else. Due to the nature of our work, there is a lot of turnover, but supervisors will give their arm and leg to recommend staff for positions elsewhere. This is at a university, so our flexibility is unique. I realize that most people working in the field don't have the luxury to just say they need a few days off.

Giving myself permission to leave - I've already promised myself that if I have a certain number of days in a row where I hate doing my job, I will leave. Having a diversified career is something I already expect to have, and (I think) have made my peace with.
posted by gollie at 6:23 PM on March 27, 2016 [2 favorites]


Celebrating the smallest victories - it's difficult to see the same clients struggle with the same difficulties again and again. I just remind myself to stay in the present, where the client is now, and give recognition to whatever step they've taken that day. While the big picture is important, it can be overwhelming.

Yes yes yes! So important. One of the reason I think it's important to manage my own expectations for realistic goals in realistic timeframes is that it gives me a much more realistic scale, so to speak, to measure a client's progress, which makes small victories stand out much more. As an analogy: If I was told I had to coach someone who was currently totally sedentary to run a marathon in a month, then I'd likely feel that every training session was a failure, because it wasn't enough to reach the (unrealistic) goal. If I was told I had to coach a sedentary person to run a marathon in two years, then I'd be able to see every training session as an opportunity to improve on the last one, and be able to contextualize bad days as just a normal part of the process. (I hope that makes sense? I don't run, let alone marathons, so insert a better analogy if it's more helpful!)
posted by lazuli at 6:36 PM on March 27, 2016 [2 favorites]


I work for a labor union - started as an organizer, now work as a researcher. I got in because I wanted to change the world, but I quickly learned (and was taught to recognize by my mentor) that I had to find a personal connection to the work for it to nurture me, not deplete me. It's taken some difficult periods in long campaigns, but through the conflicts I've come away with a deeper connection to the people around me and my work in the movement.

It's obvious that lots of other people get benefit from what you do, but - what do you get out it? Does it seem to be nurturing you or draining you in the long run? It's ok to sit with these questions for a while and not find a answer - it's been so easy for me to get so bogged down in the day to day at times that I find it impossible to listen my heart. If the answer you find is that this job takes more from you than it gives back, consider a reorientation of what uses your skills and passion could be put towards. Unions, for example, hire lots of organizers, grievance reps, and other staff with your background in social work.
posted by roll away the dew at 7:19 PM on March 27, 2016 [2 favorites]


Meditation, which is a variation of the self-care theme.

It's exactly as described by the FAA/flight attendants instruct on pre-takeoff procedure: put your oxygen mask on first before you help anyone else in the cabin put their masks on.

This is much easier to say than to practice. Good luck!
posted by honey badger at 4:35 AM on March 28, 2016


17 years in psych institutions and wards here.
I get it.
The world is cruel and unjust and my ability to help is limited.
It sucks, but I can't change it.
When I feel down I usually ask myself if it would make the world a better place if I left. So far the answer has been no.
Also, I try to look at my shortcomings with the same kindness that I try to show my patients.
Good advice upthread about celebrating the small victories.

But importantly not everyone is cut out for this. At least not full time or at any given time of their life, or in any given organization. It may sound harsh, but really isn't. If you end most of your days feeling depleted, angry and hopeless, it is high time to reassess whether you can do the job or it is time to move on. Not being flippant.
Burnout is not to be trifled with. I'm wondering where your supervisor and colleagues are in this? Have you discussed your feelings with them?

Because this is not all on you. It is the duty of any organization that does this kind of work to take care of situations like this. If they don't, get out.

A few questions off the top of my head:

Depletion

Where do you get your energy from? Inside and outside work? Colleagues, supervision, hobbies (important!), meditation? Can you replenish more? Can you - perhaps temporarily - cut back on your workload?

Anger

Sometimes a secondary emotion on top of sadness. Can you accept the shitty reality you are in? Can you get help to do so?

Hopelessness

What are you hoping to achieve with your work? Are your goals realistic? Can you adjust your goals and find satisfaction in a more limited impact of your work? Is the support structure at your workplace sufficient to do this kind of work?

Best of luck and take care!
posted by Thug at 5:18 AM on March 28, 2016 [1 favorite]


Best answer: Thank you for asking this question; it led to a great conversation with a relative who has been a psychiatric nurse for 17 years and works with a similar clientele.

My summary of what she says:

- I have decided to work on the front lines of this problem. That's my contribution. I try to focus there and understand that the work of systemic change has to be done by others. I know that until this happens, there are very real limits to what front-liners like me can accomplish.

- I commit to my process, not my client's outcome. I try to be as good as I can at doing the job, and hope that contributes a bit to the odds that the person's outcome will be good. If I'm asking open-ended questions, I make them the best I can. If I'm going through a symptom checklist, I'm efficient but kind. How good I feel at the end of the day depends on how close I came to doing my best, not whether the client did what I wanted.

- I try not to participate in the hopelessness/anger/venting of certain colleagues. Everyone needs to vent, including me. With some colleagues, it's cathartic, but with others it just feeds a sense of futility and/or excuses them for no longer trying to do their job well. With the latter crowd, I listen politely if I'm stuck, but try to change the subject quickly.

- I spend time in nature, ideally while exercising vigorously. Both are calming and seem to put things into perspective.
posted by Frenchy67 at 7:02 AM on March 28, 2016 [2 favorites]


Healthcare worker here to chime in.

Sounds cheesy, but I have a beautiful blank notebook (cheap ones to be had at TJ Maxx if you aren't ridiculous like me and have dozens lying around "too pretty" to write in...) which I keep at work and at the end of every day I write down a single nice/helpful/thankful thing a patient said that day. Some days there aren't entries, but seeing them build up and being able to tangibly flip through a small archive of undiluted positivity is so helpful.

In a similar vein, I keep an email archive folder entitled "makes me happy," which only holds nice things people have sent--congratulations on publications, thanks for help, birth announcements, etc. I don't even bother to go back through it, but just seeing that folder in outlook makes me smile every time.
posted by eglenner at 7:57 AM on March 28, 2016 [4 favorites]


Response by poster: Hi all, thanks for the suggestions. The suggestions I'm noting and trying to remember are:

• Get support from mentors and coworkers, and also have people to talk to outside of work
• Venting with colleagues can be helpful, but it can also be harmful depending on how they’re venting. Be judicious about this
• Take the maximum allowable time off and push for more than that
• Use work time to also build in sanity breaks and mentorship
• Leave work at work
• Consider having a ritual to end my work day
• Have engaging hobbies and community outside of work
• Spirituality, sleep, rest, nature, meditation, exercise, self care and self-compassion
• Don't be a hero at work - I'm not the only person who can help
• Recognize and notice the victories of my clients and acknowledge these victories may not be enormous or come quickly
• Be organized at work
• Do what I do well, and tie my feelings of accomplishment to doing my best work, rather than to specific outcomes on the part of the client
• Examine if I personally can sustain this kind of work

Thanks all so far. I may print out these answers and put them in my desk drawer to peek at.
posted by latkes at 8:01 AM on March 28, 2016 [8 favorites]


Best answer: I've worked in the homeless field for 20+ years. And I cycle through times of feeling like all I'm doing is applying bandages - to times of being exhilarated by the work. Lots of frustrations in this field, from the revolving client door - to poor wages, poor management and poor supports for workers.
I'm sure you are aware of the The Homeless Resource Cente that has numerous articles on self-care. I'm a big fan of Ken Kraybills work - and somewhere at that site is his manual on self care.
Learn to turn the work off - which is sometimes challenging. A co-worker separated her work keys from her personal keys - and when she goes home, she puts her work keys in a bowl - and those keys are not touched until the next time she leaves for work. It helped her a lot on being able to 'shut down' the work thinking.
Good boundaries at work - be really clear to clients what you can and cannot do for them.
Getting proper breaks and time away - when at work.
Get involved in a local homeless committee - and do something on the committee that you feel is important.
As a team, in weekly client reviews, we take time out to reflect on the positive attributes of particular clients. I even have staff write them out on a flip chart. It's so easy to get stuck in the negative.
Team exercises - if you are asking "why am I here?" - then others are too. Team exercises around: why we do this work; what we like/dislike about this work; to self care as a team - can bring in a lot of new energy. We did a 'team resume' - it created a great sense of unity but also admiration of all the skills we bring to this work.
Bring in guest speakers/trainers - other people who are making a small differences in their community. Again - a great energizer. Or an opportunity to learn a new idea/skill.
Read/study/practise Motivational Interviewing techniques. It works! It teaches you how to step back and let the client do the work. Practise, practise, practise listening and reflecting, rather than problem solving.
Find an area of the work that piques your interest and make it your niche. For example, in the last few years I have being doing work around seniors homelessness and also, making homeless services more transgendered friendly. Two areas where not a lot of people are talking about (at least in my community).
Change something up - redecorate an office or client area (with client input).
Ask clients why they come to your service. Make a large mural where they can post comments, pictures, poems, stories. A great reminder to staff, volunteers and clients of why we are all here.
I usually have practicum students around - they are always energetic and eager to learn. I've enjoyed being able to share what I have learnt - but I also enjoy watching them grow and develop. I get many calls from previous students who comment on what a rewarding experience they had. Be a mentor for someone who is eager to learn!
Always remember you are making a difference!.
posted by what's her name at 9:13 AM on March 29, 2016


Response by poster: Hey, great ideas from someone in my same work, really helpful. Especially taking this one to heart:

Get involved in a local homeless committee - and do something on the committee that you feel is important.
posted by latkes at 5:40 PM on March 31, 2016


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