How to avoid burnout when treating depressed people
Depressed clients can hypnotize you into feeling as depressed as they do – here’s 3 key ways to protect yourself!
By Mark Tyrrell
Depression is infectious. At one time it was thought to be inherited - although no gene has ever been discovered for it. (1) And it's no longer considered to be caused by 'brain chemistry', although it does cause chemical alterations while it lasts. Now when I say 'infectious', I mean social infection. We can be infected with attitudes as surely as with microbes. Just think how low self-esteem can spread throughout whole departments in a place of work!
If you work with lots of depressed people you need to protect yourself from being infected by it. Here's a few smart ways to avoid burnout. After all, you can't help someone who's drowning if you get pulled in too!
- Focus on process not content
It's easy to get sucked into the negativity and hopelessness of a depressed person's world view. The details of their lives are important, of course... up to a point. But to stay out of the 'quicksand of despair' ourselves we need to focus on the larger processes that are going on and not so much on the despairing detail. Look at what a person is doing not just what they are saying.
For example: Are they too 'all or nothing', too 'black and white', in their thinking? Are they minimizing and skating over the positives in their lives while magnifying and dwelling on the negatives? Is their thought circular and lacking solution focus?
Look at the patterns and think objectively and strategically as well as empathically to stay free of the 'depressive trance'.
- Meet your own needs!
Burnout happens when we continually 'give' without getting what we need ourselves. Everybody (including therapists) needs:
- a sense of safety and security
- attention - giving it and getting it
- friendships: fun, love, and physical and emotional intimacy
- a sense of control and autonomy
- a sense of being part of a wider community
- mind and body health - relaxation, rest, exercise and nourishment
- a sense of purpose and meaning
- a sense of status
Trying to work with seriously needy clients without ensuring that your own needs are met is like setting out on a long journey with an empty fuel tank. Your clients are seeing you because they are having problems getting their needs met. When you purposefully get your own needs met (for the greater part) outside of your work context, you create 'spare capacity' within yourself to stay fresh and effective for you clients. You'll also enjoy your work more.
- Don't be everybody's therapist
Even Superman is sometimes just plain old Clark Kent. People sometimes expect me to want to talk 'deeply and meaningfully' when I'm out socially, or else constantly regale me with their problems. Sometimes I don't mind, but there are limits - and you need to set them. Of course, we all want to be there for our friends and family but people can come to see you as 'therapist' first and 'person' second. Gently remind people (especially if you're not that familiar with them) that it might be a good idea to book a session with you, as here and now (at Jim's barbecue) is perhaps not the best time to talk about this - and anyway you're in the process of re-charging your 'therapeutic batteries' :-)
(1) Depression is ten times more common in people born since 1945 compared to people born before 1945. So, ten times as many people are becoming depressed now as compared to sixty years ago (taking into account increased reporting and public awareness). Biology doesn't change this fast. Genes don't alter this rapidly. So this is a clue that clinical depression and its increase are more to do with the way society and lifestyles are changing.
Depression is not an inevitable consequence of adverse life circumstances either, as only a minority of people exposed to difficult situations go on to develop clinical depression.
See: David O. Antonuccio, William G. Danton, Garland Y. DeNelsky, 'Psychotherapy Versus Medication for Depression: Challenging the Conventional Wisdom With Data', Professional Psychology: Research and Practice, December 1995, Vol. 26, No. 6, 574-585
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