Why So Many Therapists Are Exhausted and What’s Really Going On

Camille McDaniel (00:28)
Welcome back to Christ in Private Practice. Thanks for joining me for another episode. So today I want to talk with you about something that has honestly been sitting with us, I think many of us, for a long time, but now it is front and center stage. Now you cannot ignore it. And what I’m talking about is burnout. But stay tuned, because this is not.

the typical burnout talk, let’s talk about, you know, taking a walk and all of that. Let’s really break down what is going on here because in this day and time, especially, there are a lot of us who are carrying…

more than we feel like we can carry or it’s breaking us down at this point in time, we want to look at what’s going on. We have a lot happening in our world. Our clients are experiencing that. They’re coming in, processing that in addition to whatever brought them to us in the first place. We are feeling it in our personal lives and we need to still show up as professionals for our clients and it is a lot.

And I’ve seen a lot of conversations happening in online spaces that tell me it’s not just in my own mind, it is very real, and it has people really making some tough decisions or at least thinking about making some tough decisions. So let’s go ahead and actually talk a little bit about what it is, about what we can do. Let’s break it all down, okay? Like I said, this is not…

This is not just the casual, you know, I think I’m burned out. But this is really showing up in a lot of spaces and it’s affecting how we feel about ourselves. It’s affecting how we feel as far as our confidence in being able to even stay in the field for some of us. ⁓ I don’t want that for any of us. I don’t want us to be pushed out before the Lord calls you to move. And this burnout also is not just part of the job.

We don’t want to just normalize it as, it just comes with the territory. ⁓ I think we could probably do it a little bit differently so that it doesn’t have to feel like something that you have to just carry for the duration of your time as a mental health professional. So.

One of the biggest challenges that I do see or I do notice is that therapists are feeling something. We’re not always putting language accurately to what exactly is going on.

Camille McDaniel (03:06)
I want to pause here just for a minute because this is actually something that I see come up often in our field. Sometimes what we’re labeling as burnout or emotional depletion isn’t always purely psychological. There are times where our physiological issues can present in ways that look like anxiety or depression, fatigue, or even brain fog. And if we don’t recognize that, we can end up trying to treat something from the wrong angle.

And that’s exactly why I wrote the book, Medical Mimics, a guide to distinguishing physiological from psychological symptoms. It’s designed to help clinicians and even clients begin to recognize when something might need a closer look medically, not just emotionally.

So as you’re listening to this podcast and reflecting on what you’re feeling, I want you to keep that in mind because clarity is what helps us to move toward the right solutions.

And now back to today’s episode.

Camille McDaniel (04:05)
Sometimes we know and sometimes we don’t know. And because we’re not always putting the exact language to it, it can sometimes get in the way of being able to address it accurately. And so let’s look at just some of the things that get all mixed up together.

like it’s all the same thing but it’s not really all the same thing if we break it down and so the first thing is fatigue or being tired and that’s something that comes up but it’s not the same as being burned out I mean it is what it says it is, it’s just we’re tired.

were fatigued, you know, and it’s something though that you could recover from. Like if you’re tired, you know, you generally might have had like a really long day. Maybe you’ve had a really full week or it could even be that you’re in a season where there’s just a lot that you’re having to take care of and so you are feeling tired, you’re fatigued. ⁓ But I will say though, you do notice a shift

once something happens.

oftentimes when you actually are able to give yourself some rest. When you actually get a good nap or when you just get a full night’s sleep, then you may notice that, you know, I…

I feel totally renewed or I feel totally energized or maybe you take off the weekend and just go and do something that’s absolutely relaxing or you might go somewhere that and you don’t lift a finger pretty much, you know, unless it’s something that you really desire to do and you feel filled up and now you’re ready to move forward. You’re ready to go again. Your capacity has been renewed. And so that is totally different than what we’ll talk about in a minute with burnout.

And the next thing, because after feeling tired or fatigued, sometimes we ⁓ recognize that we are overwhelmed. We’re overwhelmed. And when we’re talking about feeling overwhelmed, it’s really saying there is just too much on me right now.

there is an extreme volume of something, whether that happens to be work, whether that happens to be taking care of parents and taking care of children and doing something else that you do on the side. There’s just a lot going on and that’s putting a lot of pressure on you.

that could be that you have right now, too many clients. And that’s in some ways a good problem to have, but also comes with a lot of responsibility and a lot of weight, depending on who you actually help, what your specialties are. Maybe you have too many responsibilities. Maybe you are managing a lot of things. Maybe you’re…

too many roles. I mean, we have a lot of roles in our life. Maybe you have, you know, kind of overextended yourself here. But even with overwhelm, here’s the key. Overwhelm can actually correct itself, can be relieved with adjustments.

you can start practicing, ⁓ I’m sorry I can’t, you know, when they say start practicing, no. Start practicing being able to say ⁓ I wish I could but I can’t. Maybe you don’t wish you could, so don’t say that, you know, keep it honest but whatever it is be able to share ⁓ what you are able to do and not able to do. Maybe it’s that you have to then actually delegate some things ⁓ so the

whatever it is again you just are going to make some adjustments in what’s going on currently and then that way you don’t feel overwhelmed or overextended really. Overextension ⁓ is what can create overwhelm and with regards to clients it might be that at this time you can’t take on more clients. You know there are there are times where you might have to you know evaluate that.

Now let’s look at those two things that I just mentioned as it relates to burnout. Because burnout is different.

So with regards to burnout, now you’re getting into an area where you’re just saying I just don’t feel like myself anymore and I don’t know if I can carry on because it oftentimes includes like an emotional depletion, total depletion. Emotionally, it might be total depletion ⁓ as far as your intelligence and I know that can sound silly but you know how sometimes people are like I know I’m an intelligent individual

why can I not think this through? Why can I not process this? Why will my mind struggle or seem to just auto shut down when I’m trying to find a solution, right? Yeah.

That’s that’s under burnout. know, the other thing too is like, because burnout has extreme symptoms. So even feeling numb, feeling totally numbed out, feeling totally disconnected, you know, your mind’s just not registering anymore. It’s like, we’re done. We’re done. We’ve got nothing else. You know, the well is dry.

type of thing. And that can actually reduce your feelings of being effective ⁓ in both your personal and your professional life. You may be questioning your capacity. You may be questioning your calling. And so.

here’s what makes the burnout really concerning is that with burnout, the rest, that nap that I was talking about earlier or that really good night’s sleep, maybe even the weekend of doing nothing, it doesn’t fix it. It’s like you felt good, ⁓ you know, when you took the nap or you took the ⁓ rest or get away, whatever you did, you took that

And then you still had to go back to your regularly scheduled program the next day or two and then all the floods right back. You know, you’re kind of like still waiting for things to return back to normal and they don’t. So let’s talk about why this is happening.

And there might be some things in here that you’re familiar with, but there also might be some things that we talk about that maybe haven’t really crossed your mind. And I hope that it gives you maybe a new way of looking at things, some new revelation. if we are honestly talking about this, ⁓ it’s like what’s fueling it. If we start talking about ⁓

what’s behind burnout, then we need to maybe look at some things that even involve our career, ⁓ maybe even involve our personal life, because it’s not just about not taking enough jogs or walks in the park or ⁓ not taking enough ⁓ time to read or listen to music or so. It’s not that, right? There’s some deeper dynamics at play when we’re talking about burnout.

out and it’s good for us to connect with what’s happening with us so that we can get to the right solution for what you might be experiencing.

One of the dynamics that could be at play has to do with the emotional labor and the isolation that a lot of therapists experience. You know, as therapists, we’re sitting in spaces where people are, you know, under extreme pain. They’re processing trauma. They’re letting out. They’re, you know, kind of offloading, if you will, their pain, their trauma, their worries, their depletion.

their hopelessness. You know, they’re wrestling with loss and suffering and who they are at this season of their life. you know, ⁓ we…

we often kind of have clients scheduled back to back where we are hearing these things hour after hour after hour. And there may be very little time for us in our schedules and sometimes schedules that we have created for ourselves, sometimes schedules that people have created for us, but there’s very little time in the schedule to emotionally release what we’re hearing.

what we are helping people process, what we are having to intervene ⁓ on. And then after that, we go home. And then we’re expected to like switch, know, just tuck all that away and just switch. But here’s the truth about that. The work.

accumulates. There’s an emotional accumulation of everything that you take on and for those of us who are integrating the spiritual there is an emotional and a spiritual accumulation if you are not releasing these things and it does begin to weigh on you. It will. Many of you are already feeling it.

So you know outside of just the emotional labor and sometimes even the isolation that comes with being in practice for yourself or being in a group practice or an organization where you don’t get a lot of consultation or supervision if you happen to be in your early, early starting to the career.

or if you happen to be that, you know, there’s not like a multidisciplinary team approach, there’s a lot that contributes to why people feel isolated. And so we need to know that in addition to that, there’s another reason. There’s a couple of reasons that I’m gonna go over in this episode. But the next reason that we might find ourselves at burnout is because we might be carrying a lot of…

clients and at this particular time they’re not ready to finish their counseling journey with us. So we really have not been able to release any clients and this can actually happen kind of subtly really just a slow build up as you bring on clients but everyone is still at different stages of their journey and not quite at the end.

And that can cause a different effect

One where we find ourselves carrying people within our minds and within our hearts for a long period of time. You might even notice that maybe you are thinking about them after sessions, thinking about, ⁓ you know, the challenges that have not been resolved or new challenges that are piling up that have just taken them three steps back. You may notice that you’re trying to solve things

even outside of session time and you might notice that you’re kind of sometimes having to pull yourself back from feeling responsible for the outcomes that your clients are having and over time what happens is that this kind of shifts from compassion to now feeling fatigued which is why there is a thing called compassion fatigue. Right? It’s just

not a sustainable ⁓ way to do things, it’s just not. And then we have business pressure that’s in private practice that also can add to the feelings of burnout because this is something that isn’t really talked about enough like burnout as it relates to being a business owner or business operator.

if you aren’t the owner, but you’re operating, even if you happen to be ⁓ a 1099 contractor within someone else’s business, ⁓ this is a lot, you know? You’re not just a therapist. You’re the clinician in addition to the marketer, the biller.

the decision maker and even if you’ve outsourced certain things like maybe you’re not the scheduler, maybe you have you know outsourced that, maybe you’re not the biller, maybe you’ve outsourced that but you still have to make sure that these things are being done properly so you are the person who is making sure to check everything, you are the checks and balances okay and sometimes that that can all be a lot, it can.

And then in addition to all of that, guess what? Guess what? For many, for many of you listening, the amount of money you make depends on how much you work. If you get sick that week, you’re gonna see something different in your paycheck. If an unexpected emergency means that you have to shift clients, but the days you’re able to shift them to, they can’t come,

There’s pressure. It’s an interesting journey. A very interesting journey. And so that can add to why sometimes burnout is not corrected because for some of us, people are thinking, if I slow down, I’m gonna lose. I’m not gonna win. even that little belief right there.

can keep you in a cycle of overextending yourself, overextending yourself time and time again. And so we need, we need some some things to fix this because it again I cannot stress enough how this is not sustainable for any of us and you know you don’t fully appreciate your health until you don’t have it.

until something happens that just breaks you down. It’s just slashing your immune system. It’s just slashing your peace. It is impacting your relationships with people who mean a great deal to you.

So let’s talk about some of the fixes, how we can actually turn this around. Beyond just being self-care, mean self-care, yes, is important, but this is not just self-care. Let’s kind of talk about some of the solutions. So because when you talk about saying, hey, let’s take care of ourselves without really changing the structure around,

what’s going on that is really creating the turmoil, you won’t really find that you have actual complete, well, hey, let me just interrupt myself. It’s kind of the same way as with our clients. You know, we’re not just gonna say, hey, let’s work on feeling better. We need to actually get to the root so that we can identify what needs to be changed.

And then we can talk about ways that we can start helping ourselves to feel better after we have made some changes to the way things were operating before. So we don’t want to ⁓ try to self-care our way out of a, what do I want to say, a pattern, yeah, that is totally draining you.

So one of the things that we’re going to look at first with looking at possible fixes, some solutions is let’s take a look at our caseload, our client caseload and the way that we have designed it because not every single hour should look the same in our day for those in private practice or those who are in a group practice or those who are working in a facility or an organization.

It shouldn’t really look the same. So we want to take a little bit of an assessment. We want to ask ourselves like how many high acuity clients am I holding in one day and how many emotionally intense sessions am I stacking together because there needs to be some intentional spacing of emotional demand, not just the number of clients, but the types of challenges

Challenges that the clients are bringing well, let me tell you why I remember this clearly There was a time just based on my availability my training and you know the season of life I was in where I was helping a lot of Suicidal clients a large amount of the clients that were coming to me were dealing with intense hopelessness and Suicidal thoughts were quite frequent

I could recognize, and I will never forget this one particular time within a month, that it seemed as though most of the clients that I was serving went into crisis and the amount of darkness was so heavy you literally felt like you could touch it.

and that I could feel was also impacting me as I was standing with them walking the journey. So I definitely had to make sure that at that period of time, I stopped actually taking new clients. I can recall this because I can recall that I actually had room for additional clients and I was not able to take on new clients because the emotional requirement

capacity for some of the things that were happening as many of my current clients at that time at least ⁓ were dealing with some really dark, some really heaviness in their life and I really needed to make sure that I was aware of my own capacity and what was filling me and what was charging me so that I could show up brand new every session. Okay so we want to evaluate that not just how many

clients we have but what are they dealing with, what’s the emotional requirement from you, what is the commitment that you will need to make as far as trying to then collaborate, coordinate depending on the severity of the challenge that they are bringing and do you need to make any changes in the way that you are

seeing clients ⁓ and do you need to see a certain number of clients with severity on this day and only a certain number of clients on that day so that you’re you don’t ever get to a place where you have stacked your whole day with really intense sessions and that can actually be something that does not work well.

for everybody. The other thing that we want to look at is how we are spacing our sessions. Like do you have yourself back-to-back sessions all day ⁓ in you know in that way that is like one of the fastest ways to get to burnout. Like if that is if that’s the goal you are doing it right then but I’m sure it’s not really the goal ⁓ it’s not the goal for people to not eat all day, it’s not the goal for people to have to

hold their bladder most of the day, that’s not the goal. So even if in your schedule, you give yourself a ⁓ half an hour buffer.

⁓ depending on how people schedule their clients, half an hour might be a little bit odd and throw the schedule off but I have actually seen where some people start on the hour the first part of the day and then depending on their break, how long they take a break, then the next part of their day is like on the half hour. So you can you can schedule it the way it works for you but you should definitely be doing what you advise others to do and that’s give yourself proper breaks throughout the day so that you have

time to readjust, you have time to meet your

nutritional needs, you have time to meet needs like moving. Our job is very sedentary by and large and so you want to make sure that you’re also taking care of your health by giving yourself an emotional rest, a physical rest, time to actually move and time to reset and give yourself some mental clarity before you move on to your next session. And without thinking about this area, without thinking about how we are spacing

out our sessions, you know, you’re carrying one session kind of right into the next. You just don’t have any time to just stop, pause, decompress, even if it happens to be 10 minutes that you give yourself in between sessions, not even talking about breaks for a minute. But I mean, like when you literally are running one session into another, you have no time in between sessions to run to the bathroom, to grab a drink of water, to stand up and stretch because right after one session in,

another one begins.

been there and I’m gonna say it’s it’s not the smartest move ⁓ and I really try not to be there and sometimes I will have like back-to-back sessions. It’s not saying not to have back-to-backs but I have a certain number of back-to-back sessions in the morning and then I have a break. For me, I noticed two hours is really a sweet spot. If I can get two hours back-to-back then I’m actually really good to then go and do another four sessions.

⁓ later on or do depending on again think about what we talked about as far as ⁓ looking at the clients that we’re serving and how we are designing our caseload depending on the severity you know if they’re high acuity clients or if there is a lot of emotional distress that’s coming then sometimes I will have like you know a session and then another break and then a couple of sessions. So we want to just take a look at how we are spacing out our sessions, how we are designing.

our client load. And then the next thing that we want to take a look at is that, you know, we need boundaries with how available we are. And this is going to be, I know, a big one for a lot of you who are listening because

If you have it to where your clients can access you anytime, and I’ve heard of people saying, you know, I’ve been getting emails throughout the day and I keep trying to keep up with them and I keep trying to respond and it might even be just one person. I’m not talking about like emails in general. I’m saying people who can access you at any time. They’re texting you, they’re emailing you, they’re trying to call, they’re getting, you’re also seeing them for appointments, you know.

you will eventually feel like you’re always working, you are always on. And so clear boundaries ⁓ are very helpful. They’re not a negative. Boundaries are protection for your craft. Like you want to do what you do well, you want to be able to show up.

and show up well, not limping along and barely making it, right? You want to show up well.

but the very nature of what you are supposed to be doing in this field and how it impacts other people. There’s no way that you could work all the time answering texts, answering emails, picking up calls, seeing clients, and people have access to you all the time and you’re responding all the time late at night, early in the morning on your lunch break.

That’s no good. So if that is taking place then maybe you have to assess again.

What are the types of challenges that you treat? Do those challenges require the type of support that you can give? Like I have known that there are some offices where when they are gone for the day, they have a like an emergency coordinator. So if any calls come in and it’s an emergency, they actually have someone who can route people to get help. Some places that have staff that work different shifts

may actually have people who are then working later so that they can answer the calls. Some individuals who go home and they do not offer crisis management services at all times of the day, they’re not 24-7, they may have a message that then instructs people how they might be able to get help if they call after hours.

or if they call and the office is on a break, like a lunch break. So you wanna be thinking about who do I serve, what are their needs, and if they happen to be, know, ⁓ higher level, or sometimes it goes to higher level, what do I need to have in place so that I am not the only point of contact all the time, which then impacts your ability to be refreshed.

increases the likelihood of you going into burnout and then it impacts your impact on clients and on the way that you’re able to serve. Let’s look at it like this because

it’s not called Christ in private practice for no reason okay. You have been put in this profession to do the will of the Father. It is a calling. Some people will call it a ministry. It is a the way that you are to share your gifts and talents given by the Lord with the rest of the world and ⁓ even for yourself and it matters right okay. This is is big deal because you

how important mindset is. That’s the thing that everybody goes after. You know, it really is a hot commodity, the mindset of a human being. People spend millions of dollars to understand how to impact the mindset of human beings so that they can do more to encourage us to go this way, go that way, buy this thing, don’t buy that.

So what you are doing is major work. And sometimes this calling can be used in ways that lead straight to us overextending ourselves and total exhaustion. And so we wanna be careful that we are listening to the word of God and his instruction, because he actually has an instruction in the Bible that says that Sabbath was made for man.

not man for the Sabbath. Okay? So it’s literally like, hey, I gave you this gift, like I created rest for you. It’s not for you to have to serve like the rest or do anything. No, I’m giving it to you. Yeah, it was made for you. Take it, use it, renew yourself, refresh yourself.

so that you can continue to do the good work that I’ve said before you.

Sabbath is protection. Now Sabbath doesn’t have to be just one day a week. You know we’re used to hearing Sabbath and we think like this is the time that you know I go and worship with a body of believers. Like Sabbath though taking a rest is something that doesn’t happen to be just one day a week and when you think about it the Lord and when you read the Bible you will notice that there are times where Jesus goes off on his own into the wilderness to reconnect with the Father.

You know, he takes time. He takes time to commune. He takes time to commune by himself. He takes time to commune with others. So we wanna recognize that it’s about stopping.

because we’re human and and when we actually try to override that rhythm of being human and feeling like we can operate like machines, we will eventually feel it in a multitude of places especially depending on what season of life you are in, okay? You’re gonna feel it, you’re gonna feel it and so I want us to not ignore

what scripture instructs us. I want us to not ignore the example that Jesus provided for us. You know, he prayed, he created space, he rested, he withdrew. You know, and I want us to really lean into that. We don’t have to do more. If we’ve been given examples that guess what? It works when you honor your body as a temple. And so ⁓ we don’t have to do everything in one day.

We don’t have to respond to every single fire immediately right at that time because we can’t. It’s not even because we don’t want to, it’s because we’re human and there are limitations with the human body. Okay? So what we want to do is ask ourselves why do I feel like I have to do so much all the time?

Am I afraid of something? Am I concerned about something? Have I not turned something over to the Lord? Do I feel like maybe I haven’t gotten an answer fast enough? Am I having a hard time hearing at all? I want to leave you with…

just a few questions here as we are starting to close our time together for this episode. And this is not like to overwhelm you or anything like this. This is literally just to help you to gently just assess where you happen to be right now. Ask yourself, answer these, know, come back and replay this so that when you have some time to yourself to maybe journal this or think about it, you can answer this for yourself. Am I tired?

or am I totally depleted? Am I overextended or am I disconnected from the work that I’ve been doing? What in my current structure, what in my current practice is contributing to how I feel? And where do I need to adjust?

and not just try to push ahead and endure. All right, so if this episode resonated with you in any kind of way, I would love to hear ⁓ clearly, you know, what really helped. ⁓ It’s very encouraging for others, but ⁓ it also lets me know that I am making a difference out there. So I appreciate you just kind of conversing with me and telling me what things worked well.

And if you feel like someone else could benefit from this episode, please share it, share it, share it freely. ⁓ Because burnout is not something that we want to just accept. It’s not, that’s not something that just comes with the territory. Now, yes, there will be days where we’re tired. There may be some days where we have overextended ourselves. There may be many times where we do that and we feel overwhelmed. But burnout, hmm.

no burnout is not something that just comes with the territory where you just keep on limping along you know and so with all of that being said I I pray that you have a wonderful week until we meet again. God bless.