Psychologist and Psychotherapist Burn-Out

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This paper will first attend to the hazards that the practice of psychotherapy pose to the practitioner, then to the hazards posed to the practitioner's family. The third part describes burnout and outlines how it can be avoided. The last part provides the reader with a selected bibliography on the topic.
A. HAZARDS OF THE PROFESSION TO THE THERAPIST
1. Emotional Depletion: The psychotherapy profession consists mainly of working long hours in isolation. Therapists deal primarily with people in crisis and pain. They are supposed to offer these people support, empathy, interpretation, explanation, direction, or advice. They are expected to give endlessly while expecting nothing in return, except the fee. Not surprisingly, this results in practitioners' emotional depletion, in the therapists' sense that there is nothing more they can give to themselves or to anyone else.
2. Isolation: Not only do therapists work mostly in private settings, but also a growing number of laws, codes, and regulations concerning confidentiality and anonymity exacerbate the therapists' sense of loneliness and isolation. In addition therapists work when most people are off work. Their free time frequently arises during mornings and afternoons when friends or spouses are often busy.
3. Helplessness and Sense of Inefficiency: Unlike carpenters, gardeners, or surgeons, psychotherapists rarely see immediate, profound, or tangible results from their efforts. The work is often slow, and with difficult or charactologically impaired people, they may never see improvement. Even when therapy is effective in relieving painful symptoms and termination is successful, patients leave. With them goes the knowledge of the long-term effect the work has had on their lives. In addition, the lack of easily available scientific and measurable ways to evaluate the outcome of therapy, leaves therapists wondering whether or not they are being truly effective and helpful. They may question their entire involvement with what Freud called "the impossible profession."
4. Grandiosity and Omnipotence: Patients often put therapists on pedestals. They may idealize the therapists, ascribing to them super-human abilities to see, understand, and heal. In the private setting of psychotherapy, these projections may repeat themselves every fifty minutes. Combined with a lack of critical feedback from objective sources, this may encourage in clinicians the development of what Ernest Jones labeled "the God Syndrome."
5. Depression, Sadness and Vicarious Traumatization: Working constantly with people in pain, who feel suicidal, or are grieving over the loss of loved ones, or those severely traumatized, often takes a heavy toll on practitioners. The psychotherapist can be infected with a patient's sadness; a condition Jung called "psychic poisoning." The term "vicarious traumatization" has been introduced in recent years and has become even more popular after the events of September 11, 2001. Vicarious traumatization refers to the cumulative effect upon the trauma therapist of working with survivors of traumatic life events. It is a process in which the therapist's experience is negatively affected through empathic engagement with clients' trauma material.
6. Confusion: While some patients idealize therapists, others put them down. The healer may be set on a pedestal only to be knocked off of it soon thereafter. In fact, the higher the therapist is elevated, the longer the fall and the bigger the crash. Without objective feedback therapists often end up confused and in doubt regarding their own qualities, qualifications, and even their sense of worth or self identity.
7. Constant Worry: Psychotherapists often leave their offices worrying about whether a patient is going to follow up on a suicide or homicide threat. Whether or not they report such intentions or make a suicide contract with the patient, sleepless nights and constant worry are significant hazards of the profession.
8. Grief Cycle: The endless cycle of introductions to new patients, conducting psychotherapy, and finally terminating the relationship takes an additional toll on practitioners. Therapists need to connect and disconnect on a regular basis. In many cases they never hear from their patients after termination. When ...