Burning Out My Therapist?

[Joanne47]

Last week in therapy my therapist said something that made me worry that I am stressing him out.

I've been having unbelievable anxiety and a lot of significantly painful physical reactions to things we've been working through. Last week he mentioned that sometimes he feels light-headed during our sessions. He said he thought it was probably because we were at such a delicate point in our therapy--which is true. If he'd even looked at me the wrong way in our last session, I never would have opened up to anyone again. I know that sounds extreme, but in addition to depression, anxiety, and PTSD, I have serious social phobia. (I don't know if I will even be able to post this) It was hard enough approaching my T and asking him to take me on as a patient and it has been excruciating getting myself to the point where I could talk to him as freely as I do. I literally have nightmares about him dropping me as a patient because I just could not start over with someone else.

I have a really hard time accepting that the abuse I went through was as bad as it was. Even after my first flashback a few months after I got married (20+ years ago) and moved out of my parents' house, I minimized it and denied it. T may have just been trying to show me that if even hearing me talk about some of it was making him have a reaction, then it was okay that I was having (a far worse) one, too. And it was very--freeing? comforting? validating?-- to have him walk through that memory with me and basically say, "That would have scared the hell out of me." He's spent a year trying to get me to stop ignoring my own feelings and worrying about everyone else instead, so I don't think he would deliberately say something that would cause the exact reaction he's been trying to weed out of me.

But what if I have pulled him so far into my pain that I'm burning him out?

 

[franciemarnie]

He shouldn't be telling you his physical symptoms. He should be aware if he is empathically experiencing your physical state, but be centering himself without comment IMO.

If you are worried about him in a situation where clearly the focus should be on you, you need to look at your behavior. Do you concern yourself with how others are feeling before yourself often? This could be co-dependent behavior learned growing up with an alcoholic or the equivalent. Co-Dependent No More by Melodie Beattie is a great book to make you aware of those tendencies.

Therapy needs to be about you - not the T. You are number one now. Your needs come first. You should not take care of anyone else in therapy but you.

 

[Justmehere]

What kind of therapy does he do? Somatic, cbt, another kind, or a mix?

I don't think this is necessarily a sign that you are burning him out. Therapists are sometimes trained to use things that come up for them - body sensations and stuff - to develop greater "attunement" with their clients. They have to work hard to learn what is their own stuff and keep that out of the room, and what isn't, and what is therapeutic self disclosure and what is harmful self disclosure.

It sounds like in the moment, his disclosure was helpful to you... but now you are questioning if he is being burned out?

My therapist does somatic work, and she has told me a few times something she was feeling about the work we were doing. I have done therapy with a trauma therapist who didn't do somatic work, and they did the same. Neither therapist dumped my care or was ever burned out (although that was my constant fear and still is).

I think if he was saying this is too much, this is overwhelming me, I can't help you with this, etc... then I would be concerned. But it sounds like he is just really being attuned to you and the work you are doing, and I would actually take this not as a sign of burn out, but a good sign. He is very self aware, and that helps therapists stay in for the long haul and take care of themselves well. It also seems clear that you are allowing yourself to feel a lot, and perhaps this vulnerability is stirring up your fears of abandonment even more strongly as you do this very tough and very delicate work.

I have very strong fears of abandonment and almost anything can set them off. Even my therapist getting sick and needing to reschedule an appointment will trigger thoughts of wondering if she really just is burned out with seeing me. I have learned to just "check in" with her now and then and flat out ask, "am I overwhelming you? Are you ok with me?" and I have even asked, "would you tell me if you were getting overwhelmed by me?" She always replies and assures me that no, she is not overwhelmed and we are good. I feel dumb and needy to ask these questions, but it really helps settle out the fear and to keep working on the trauma.

It sounds like you are taking a lot of very good steps towards healing the social phobia and doing very hard work. In the midst of this fear coming up for you, I hope you don't lose sight of the huge steps forward that you are taking. You have a lot to be proud of. Keep up the good fight to heal.

 

[Lucycat]

My T has told me that sessions with me are difficult for him sometimes, but that he has his own supervision sessions with a psychiatrist to explore any issues he has in treating others. This was said when I suggested that it was not right for me to offload all my crap onto him. I wanted to 'protect' him. At the same time I would suggest ( with the benefit of hindsight) that this was also a last ditch attempt by myself to sabotage therapy and 'not go there'

It is a Therapist's responsibility to take care of themself, not the client's.

 

[Joanne47]

Thank you, everyone, for your responses. @franciemarnie No alcoholics in my past, just a lot of time spent watching a very big, very unpredictably violent person for signs of imminent explosion. Then I raised three kids with varying degrees of special needs and/or mental health issues, one of whom was also very volatile and emotionally abusive. So, yeah I pretty much always worry about other people's feelings ahead of my own. It's been a necessary survival skill. It's also one of the things my T and I have worked the hardest on.

Therapy needs to be about you - not the T. You are number one now. Your needs come first. You should not take care of anyone else in therapy but you.

Everything you just said there could have flown right out of his mouth.

@Justmehere He does CBT

I think if he was saying this is too much, this is overwhelming me, I can't help you with this, etc... then I would be concerned. But it sounds like he is just really being attuned to you and the work you are doing, and I would actually take this not as a sign of burn out, but a good sign. He is very self aware, and that helps therapists stay in for the long haul and take care of themselves well. It also seems clear that you are allowing yourself to feel a lot, and perhaps this vulnerability is stirring up your fears of abandonment even more strongly as you do this very tough and very delicate work.

You're very right, he wasn't saying any of those things. I have been feeling super vulnerable and scared. And what he said did make me feel more comfortable in the moment. Thank you for your suggestions and for helping me think straight.

I did end up asking him about it in session today, and he pretty much said just what you said, he was normally very grounded, but when something like that came up, he felt it helped him be more attuned to what his patient was going through, so he used it.

@Lucycat You are also totally right about self-sabotage. I would absolutely rather worry about my T than have to think about some of the things that have been coming up in our sessions recently.

Thanks all of you for being so helpful and so supportive. It really helped me to hear your feedback. Thank you for being willing to take the time and for being willing to share some of your stories and thoughts with me. You made me feel a whole lot better.

 

[franciemarnie]

I so know what you are talking about - the very big, very unpredictably violent person who might imminently explode. That was my dad to a tee - but he happened to be alcoholic. The alcohol brought that side of him out.

Even though he quit drinking years later, I could never quite shake the feeling that it could still happen anytime. Always watching and waiting, ever alert. Unpredictable terrorizing. The perfect formula to make PTSD oh so conducive.

 

[Joanne47]

I'm sorry you know what I'm talking about.

I don't even know what was wrong with my dad. I've tried for a long time to figure it out. As far as I know, he never touched alcohol. We didn't even have it in the house. The tiniest thing could set off his rage. I never knew what would do it.

I know what you mean about not being able to shake the fear, too. About 4 months before my dad died of a brain tumor 11 years ago, I was helping my parents move into a new house. I kept telling myself he was sick, he was dying, he needed my help, nothing would happen, but I absolutely could not stop being afraid every second that he might go off.

 

[franciemarnie]

That must have been so rough when he was dying and you were there to help and still the terror was there as it would if like me your dad was a source of the terror and abuse that gave you PTSD. It inhered to our systems. Intellect is useless. The body remembers.

Only when my dad was unconscious and was about to die did I relax, and he in his unconsciousness was finally relaxed with me too. He knew he had messed up early in my life and was never comfortable with me as an adult.

Hug if okay.

 

[Joanne47]

Certainly it's okay. Hug right back. Thank you!

My dad was the source of my PTSD. It was hard helping him that dad. I felt like I should have been able to get past my fear and just look at him as a person who needed my help, but I couldn't get around it. I did actually help a lot, but I just couldn't relax around him.

My Dad claimed to have no memory of abusing me and my siblings, so he never acted like he'd done anything wrong. He accused my brother once of making up an entire childhood that didn't happen. I think he might have had rage blackouts.

I was 1500 miles away but on the phone with my mom when he died, so I was only half there. I didn't actually see him in the last moments of his life. I didn't relax even at his funeral. It wasn't until just last week that it finally sort of sunk in that he's dead and gone and can't possibly hurt me anymore.