Chronic Stress, Burnout and Trauma
Physician Heal Thyself
I can still remember the doctor who uttered the words, ‘you could fix yourself, just practice what you preach’. More vividly than the words, the person who uttered them, and the clinic I was in, I remember how I felt. A wave of shame and embarrassment added to the existing overwhelm. I was a psychologist after all. I should know better. Surely my training meant I should be immune to the impact of such things. In one sentence I heard the doctor dismiss, rather than acknowledge, my concerns. He confirmed the message my mind had been beating me up with for months – ‘you can’t be much of a psychologist if you can’t figure this out’.
The doctor’s words were not malicious, just poorly chosen under pressure of time. He could not have known how much courage it had taken to make the appointment and sit in front of him talking about my growing anxiety and concern. He never heard how my body and mind were responding to the continuous assault on their depleted resources.
We Are Only As Sick As The Secrets We Keep
When we live a life riddled with fear about revealing our frailties and flaws, we are resigned to remain stuck. A layer of shame can accumulate on our existing sense of overwhelm. My experience at that appointment was over 15 years ago and it planted the seed of a more integrative and systemic approach to mental health. It shaped my understanding of how important robust care, compassion and mind-body practices are for those in caring roles. Positive Moves Wellbeing emerged from the growing need to care for the carers; help the helpers; and build communities of wellbeing.
When we nurture others (whether as parents, carers, front line responders, health practitioners, or leaders) an empathic nature can be both an asset and a risk. Our character strength can threaten our coping capacity when work demands are relentless and the level of need is ever increasing. Those in demanding roles, whether by choice or circumstance, can experience compassion fatigue and vicarious trauma.
An Adaptation of the Mind-Body System
The experience of trauma is not limited to the aftermath of war, terror or horrifying events. We are not immune to the impact of chronic stress, burnout or trauma in our daily lives. It can show up in the body and mind of any one of us. It might arise as we face grief and loss. It may be reflected in our response to a significant change in our family circumstances. It might emerge from unresolved guilt, or from under the weight of dealing with a chronic health condition on a daily basis, or perhaps it reveals itself in the remnants of a broken relationship. We might recognise the symptoms in ourselves, in our friends, amongst our family, or amidst our workplace colleagues. It might derive from getting too much of something we don’t need, or not enough of something we do, at a critical time in our lives.
The work of Dr James Gordon suggests trauma will come to us all in some form sooner or later and that each of us has the capacity to understand and heal ourselves. Rather than a pathological anomaly, trauma and its psychological consequences can be regarded as an adaptation of the mind-body system. To accept trauma as an inevitable human experience is confronting but it is equally encouraging to consider that managing and reversing its impact is within reach of us all.
“you are only the person you are, in the place you are in, because of all the things that have tested you”
According to Bessel Van der Kolk our capacity to destroy one another is matched by our capacity to heal one another and restoring relationships and community is central to restoring our well-being. We have the ability to learn how to better regulate our own physiology, including some of the so-called involuntary functions of the body and brain through retraining some foundational activities such as breathing, movement, and touch. We can also work to change social conditions to create environments in which we feel safe and where we can thrive. These capabilities enable us all to be participants, rather than patients, and help to reduce feelings of separation and alienation. Our wounds and insecurities are what make us human and our awareness of these enhances our skill and expertise in guiding and supporting others through their growth and development. Being able to find a sense of safety in our own bodies, connect with our inner sensations, and feel safe with other people are vital to our mental health and wellbeing.
Rather than heal thyself we need to remind ourselves that, regardless of our position, role or job title, wellbeing is dependent on being able to access the type of compassionate support that aligns with our needs.