Burnout is believed to be coined by the psychologist Dr. Herbert Freudenberger who defined it as “failing, wearing out, or becoming exhausted through excessive demands on energy, strength, or resources” [1].

At times, graduate school seems synonymous with burnout – it is a multi-year, grueling process of hurdle after hurdle.

There is often a mentality in graduate programs that this “suffering” is a right-of-passage of sorts, an initiation that all therapists before us endured and overcame before entering the profession.

However, the reality is that these expectations and this laissez-faire attitude, when left unchecked, can produce burnout that is of detriment to not only the physical and mental health of graduate students but also to their productivity and quality of work. Unfortunately, for many in the psychology field, this experience does not end with graduate school.

The Additional Demands of a Therapist-in-Training

As humans, we all face personal, social, and environmental stressors throughout our life that can lead to emotional and physical distress.

However, as therapists-in-training, we are faced with the additional demands of a profession that is filled with chronic stress, with the stress coming from such things as working with challenging clients, managing paperwork, dealing with finances, and, most importantly, bearing witness to the suffering of others.

As a result, therapists-in-training are particularly prone to experience burnout. In a national survey of 562 licensed psychologists, over 60% reported moderate to high levels of emotional exhaustion [2].

Higher rates of burnout were associated with being younger, having a lower income, feeling a lack of mastery or being over-involved with clients, and working in the public sector. On the other hand, the number of clients seen and social support outside of the workplace were not found to be related to burnout.

Surprisingly, despite the emotional demands of their jobs, less than 5% of the psychologists reported experiencing a lack of personal accomplishment, and over 75% reported that they would still stay in psychology if they could live their lives over again.

Being a therapist is a rewarding profession, and most of us love what we do. However, some large stressors are inherent in this field, and care should be taken to avoid burnout.

What Does Burnout Look Like?

According to Maslach and colleagues [3], there are three dimensions of burnout. These dimensions often overlap, but it is also possible only to experience one or two at any given time.

Dimension #1: Exhaustion

Exhaustion is explicitly stated in the definition of burnout, and it is a telltale sign that you may be experiencing burnout. It can come in multiple forms, and you may experience one or multiple of the following types of exhaustion (with symptoms listed below):

Physical Exhaustion

“If I close my eyes just for a second I will fall asleep.”

  • Difficulty sleeping
  • Changes to appetite
  • Persistent fatigue
  • Increased frequency of illness or other physical symptoms (e.g., headaches)

Emotional Exhaustion

“If one more bad thing happens today I am going to cry.”

  • Symptoms of anxiety
  • Symptoms of depression
  • Anger

Mental Exhaustion

“My brain feels like mush and I cannot think myself out of a paper bag.”

  • Reduced concentration
  • Memory problems
  • Poor attention

Dimension #2: Depersonalization

Depersonalization occurs when you try to detach or distance yourself from your clients so as not to see them as human beings but rather as just part of the job.

This results in cynicism and a feeling of indifference for the people you work with. Although some boundaries are important in preventing burnout, depersonalization may reflect that you are disconnecting from your clients, which can drastically damage the therapeutic alliance and thus the clients’ outcomes.

Be on the lookout for:

  • Not being “present” with the client in the room (e.g., zoning out)
  • Getting reactions from the client that suggest you are not on the same page or you do not understand them
  • Being less diligent with responding to clients (e.g., returning calls or emails)
  • Experiencing greater impatience or less understanding with the people you interact with

Also, be aware that this can spill over into your personal life (e.g., isolating yourself from others).

Dimension #3: Lack of Personal Accomplishment

Burnout can result in feeling ineffective in the workplace and can appear in a number of different ways:

Feeling “Useless”

In your role as a therapist, you may feel hopeless about your ability to help your clients. You might hear yourself saying “Why do I even bother?” or “What is the use?” This may result from being emotionally drained or detached from your work but can lead to less fulfillment in your job.

Poor Productivity or Performance

If the quality and/or quantity of your work has decreased, this may be a sign that you are experiencing burnout. This may also present itself in acts of avoiding work, such as coming in late, leaving early, calling in sick, or even leaving a job altogether.

Poor Job Satisfaction

It makes sense that someone may be less satisfied by their job if they do not feel personal achievements at work. Although it may be difficult to identify whether we are doing a “good” or a “bad” job, it is much easier to for us to say “Am I enjoying this?” Therefore, loss of enjoyment in your work may be a first clue that burnout is present.

 

If you are experiencing any of the symptoms listed above, it is important that you take note immediately and begin to address how you can approach your job so as to reduce the impact of burnout.

The next article in this series will discuss strategies that you can use to prevent burnout before it occurs and treat burnout if it does happen to you.

 

References

[1] Freudenberger, H. J. (1975). The staff burn-out syndrome in alternative institutions. Psychotherapy: Theory, Research and Practice, 12, 73-82.

[2] Ackerley, G. D., Burnell, J., Holder, D. C., and Kurdek, L. A. (1988). Burnout among licensed psychologists. Professional Psychology: Research and Practice, 19(6), 624-631.

[3] Maslach, C., Schaufeli, W. B., and Leiter, M. (2001). Job burnout, Annual Review of Psychology, 51, 397-422.

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Meagan Graydon

Meagan Graydon

Meagan Graydon is completing her Ph.D. in Clinical Psychology and Behavioral Medicine in the Human Services Psychology Program at the University of Maryland Baltimore County. Her research interests focus on health behavior change, particularly substance use, using the framework of the Transtheoretical Model. Her clinical work has included providing court-mandated interventions for perpetrators of domestic violence, assessment and rehabilitation services with individuals with neurological conditions, and treatments for veterans with substance use disorders. She will be applying for internship in the fall and hopes to pursue a career in health psychology working with veterans and members of the military.
Meagan Graydon