drkkolmes (they/them)@gramjoeldavies For me, the #burnout became much more of an issue when I started sharing the #chronic #trauma my clients were experiencing. Somewhere, oh, about 2016…the sense of collective trauma was growing. I used to treat people for issues that weren’t directly causing me distress even though I experience #sexism #homophobia and #transphobia It has felt qualitatively different since the Trump years.
David Paul, M.D., Ph.D.@drkkolmes @gramjoeldavies In my experience, #burnout is a consequence of multiple traumatic experiences (#chronic #trauma)..
@DavidPaulMDPhD @gramjoeldavies Interesting. I see this is your specialty. But I also think a lot of burnout may not come from trauma at all, but, rather, inadequate rest and recovery. Maybe you think we are speaking of the same thing?
@drkkolmes @gramjoeldavies #Burnout is typically an end result of situations/experiences that have activated the fight/flight/freeze (FFF) system, repetitively (small chronic traumas) or extremely (life threatening such as military combat). The extreme traumas can result in Post Traumatic Stress Disorder. Up regulation of the FFF system has multiple psychological and physiological consequences. Rest & recovery are always valuable, but do not address the causes of the chronic FFF activation.
Gram@DavidPaulMDPhD @drkkolmes I agree. And perhaps also fawn, if it means endless kowtowing to cold, faceless or kafkaesque establishments.
What I found pertinent about my original quote is the reminder therapists aren't necessarily (just) activated by proximity to others' suffering. In fact, if practicing with he offer of a ventral vagal presence, this impact could be low. But working in oppressive systems IS activating, for the practitioner.
@gramjoeldavies @drkkolmes The current "full" name of what used to called the fight or flight system is now: Fight, Flight, Freeze, Faint and Appease. I appreciate the word Fawn since it starts with the letter F, but it's less commonly used. Most therapists are highly empathic, and even the business world recognizes that emotions are contagious (Daniel Golman, for example).
@DavidPaulMDPhD @drkkolmes I really welcome the expansion of that model. Personally, I like "fawn" because I think it says something specific about the human context. It's roughly synonymous with "appease" but it's a social response.
Fight/flight being the classic sympathetic arousal reactions, freeze being the parasympathetic one... But fawn is interesting because, I think, it reflects what happens when the instinct to "disappear" is active while... /1
@DavidPaulMDPhD @drkkolmes... while our social engagement system is still running. When the urge toward self negation, not existing, activates in a social context then the behaviour is all about shoring up the other, elevating the other, supporting the other.
This is really important for therapy because, on the surface, it may look like presence, social interaction, but it's still activation of the dorsal-vagal system associated with trauma. /2
@DavidPaulMDPhD @drkkolmes Therapists who habitually focus on being "nice" and "supportive" could also fall foul of this and be subject to burnout more easily. It's not empathy per se that vicariously traumatises, but when it overwhelms the therapists own sense of self it can do. Therapists who fawn are particularly vulnerable to this. /3 end
@gramjoeldavies @drkkolmes This is certainly a complex area! I'm not aware of research regarding therapists who "fawn" with clients. In my experience, the old saying is still accurate: "The client can't go anywhere the therapist hasn't already been." The ongoing opportunity for therapists is continued learning, growing and #healing, in service to themselves and their clients.
@DavidPaulMDPhD @drkkolmes I am not aware of specific research either, it's true. Nevertheless, fawning is relatively commonplace, especially among compulsively caring people. It is something to be watchful of and reflexive about when in practice.