Introduction – What is burnout and why does it matter?
‘It seems crazy now I look back on it…but I didn’t feel supported or that the work I was doing was valued. .. I had nightmares about my clients, became exhausted, and stopped eating and sleeping properly. All I wanted to do outside of work was zone out in front of the TV. In the end, I felt I had no choice but to leave.’ (Helen1)
The phenomenon of burnout was officially acknowledged as a condition by The World Health Organization for the first time in 2019; they defined it as “chronic workplace stress that has not been successfully managed2.” A further explanation of burnout is offered by Mcleod and Mcleod (2014 pp 74-5), describing the findings of Christina Maslach3 • Burnout has, according to their summary of her research, three characteristics: • Depersonalisation (seeing clients as ‘cases’ rather than people) • Emotional exhaustion • Disillusionment and lack of personal accomplishment
Why does this matter? Because, as Dunnett et al (2013 p183) state: ‘Maintenance of the counsellor’s mental and emotional health is an undeniable prerequisite for the exercise of effective professional activity’
We know that burnout affects therapists both personally and professionally. Cooper (2008 Pages 82/96) summarises evidence of the professional implications, adding that research shows that therapists with high levels of wellbeing have better outcomes. Tim Bond (2001) considers the personal aspect; talking about the responsibility counsellors have for monitoring their well being, Bond asserts: ‘The optimum standard [of self-care] would include periodic reviews of whether providing counselling enriches the counsellor’s life’ (page 170) and goes on to say that burnout may even lead us to question whether we want to continue in the profession.
The insidious nature of burnout may mean that we don’t recognise it until damage has been done. So, the question arises as to how we can avoid these dangers. Advice proliferates and you can find numerous lists of strategies – eat well, sleep well, have fun, mix with people who do you good … and so on. However, as a Rogerian, I believe in the uniqueness of each individual. How can anyone know what is best for anyone else? My proposal therefore is that we each need to take responsibility for our own personal and professional wellbeing, and, I’d like to suggest ways we can do this. A plan for self-management The following cyclical diagram suggests a way of ensuring self-care is appropriately managed:

The 5 stages can be worked through continuously: 1. Self-awareness I write in a time of lockdown, which may offer an opportunity to enhance self-awareness and to examine one’s philosophy about how to live a more rewarding, fulfilling life. I suggest considering: • As a practitioner, when have you felt most inspired and fulfilled? What for you makes the job worth doing? • When have you felt most tired? Perhaps you find certain aspects of client work are more demanding, or this could be about your personal circumstances. (Tiredness is your body telling you something!) • Map your resources (Mcleod and Mcleod 2011). Draw yourself at the centre of a large piece of paper then around this do drawings etc to represent people and things which support you. This can remind you how to access help, kindness and company when you need it • Identify your personal traits and qualities. (see BACP guidance sheet 088 )4 Which characteristics help you in a crisis? Confidence in your own strengths, alongside self-compassion and resilience contribute to avoiding unnecessary stress or negativity • Are your thinking styles positive? Reframing5 involves thinking about events in different ways and interpreting them more helpfully. By focussing on learning from setbacks, you can develop a growth mindset 6 • What constitutes (for you) a good work/life balance? Whoever had an epitaph that read: ‘I wish I’d spent more time in the office’? Work stress a serious contributor to burnout. Those working in a setting may experience pressure through the demands of the service; private practitioners may worry about getting ‘enough’ clients or feel isolated from colleagues. How much time do you spend away from work, engaged
with people and activities you enjoy? It is useful to create a pie chart, to look at how you use your time, over any 24-hour period:

After a few days, see if the results show a desirable balance. Remember: ‘The time to relax is when you don’t have any time’ 7. • What gives you spiritual nourishment? Sutton and Stewart (2008 p187) quote Mother Theresa: ‘To keep a lamp burning we have to keep putting oil in it’ What feeds your soul? This is not necessarily about religion, but resides in the here-and-now felt experience. For many, being in touch with beauty – art, music, nature – lifts the spirits. Learning to live in the present moment (some might say ‘mindfully’} is good practice, but it’s enough just to

• Take a ‘helicopter view’ of your life: Are your priorities and hopes the same now as they were when you first started? Do you have a clear future pathway (where will you be in 1/3/5 years’ time)? • Lastly, explore your own identity and integrity; finding meaning in your life, knowing who you are and what matters to you, is fundamental to your emotional and mental wellbeing. A wise tutor once invited us to spend a whole day identifying our core values, and to examine how much we live according to these. I still return to this often By this point, you should be able to clarify what experiences are most important in your life. I don’t know what these would be for you, but for me, currently, they are: peace the natural world creativity laughter Of course, other people would choose different things – contributing to the community, physical activity, time with family, etc. It’s up to each person to find their wellbeing factors. 2. Assess current practices By now, it should be clear whether: • you need a new challenge (or a new supervisor!) to invigorate your motivation, or, conversely, you want to scale back in your professional work • you want to develop in a new direction, or gain new qualifications • you are spending too much time on activities (or with people!) you don’t value or see as worthwhile • you need to have more fun/rest! Now consider – if you could make any changes you like to your life, what would these be? For instance – are you happy with where you work or are you ready for a move? Are there new things you would like to learn? What are your unfulfilled ambitions? Many people don’t recognise how much power they have to make choices in their lives. Yet ultimately, your wellbeing depends to a large extent on your own decisions and actions. Beware of being sabotaged by Negative Automatic Thoughts8 such as: • It is selfish to put myself first • I should always work hard • I shouldn’t do things which incur disapproval Most of these (as CBT teaches us) can be challenged. I believe there is such a thing as ‘healthy selfishness’ which involves taking care of yourself so that you can become 1ully functioning19 and thereby benefit both yourself and others. 3. Share the experience and get feedback The most protective factor of all, says Maslach, is something that counsellors tend to be good at – human relationships: ‘Research about work and psychology for decades has shown that we are better able as human beings to live life, do well and cope, and be generally healthy if we have good relationships with other people. The more people wehave who are fun to be with, teach us, and support us, the better off we are. ‘3 5 So, a large part of self-care is cultivating caring and supportive relationships. Mcleod & Mcleod (2014) also talk about the ill-effects of isolation. Therapists (especially those in private practice) may lack social support. Perhaps this is truer than ever during the lockdown experience! Many of us are lucky enough to have friends, colleagues and family with whom we can share our experiences. As professionals, dealing with vulnerable and fragile clients, we are also ethically responsible for the quality of our work.10- ln her excellent chapter (Carroll and Tholstrup ed 2001) Penny Henderson discusses supervision and the mental health of the counsellor. She explores aspects supervisors should be looking out for in their supervisees – such as evidence of motivation and resilience – and looks at how depletion may affect the counsellor’s professional work as well as her personal wellbeing. She suggests: • Regular reviews to explore motivation • Discussion of support the counsellor has, whether in the form of relationships or rewarding activities • Help to develop what she calls the ‘Velcro solution’, where our protective emotional layers can be removed for intimacy, but re-connected for resilience • Clarity about boundaries and limits If supervision doesn’t leave you feeling at least ‘restored’ (one of lnskipp and Proctor’s three functions of supervision11) or, preferably, energised, motivated and satisfied by what you do, perhaps you need to confront the question, ‘Why am I doing counselling?’ 4. Plan some changes! ‘Plan for your future because that is where you are going to spend the rest of your life’ (Mark Twain, quoted by Trevor Powell) Many of us continue along familiar pathways without ever stopping to think about whether we might benefit from doing things differently. Yes, sometimes fate intervenes, and yes, we live in the real world and there are bills to pay etc, but the fact is that in very many ways we choose where we are in life. When people say, ‘Oh, but we’ve got to work all these hours to pay the mortgage,’ I ask them why don’t they get a smaller house? There is a difference between need and want! To improve wellbeing, we must be absolutely clear about our priorities and commit to making any necessary changes. This sounds like hard work but often, when human beings are embarked on a path that feels right and exciting, they find ways of doing it, however demanding! (I have just been watching Captain Tom raising millions by walking round his garden at age 99!) If every journey begins with the first step we must stop prevaricating and make a plan! Some people like to do this formally, others work in a freer, more flexible way. Whichever you prefer, I suggest that the important elements of a manageable plan include: • Identify changes you would like to make (some people call these ‘goals’), from getting a comfier chair to moving to a different practice; from expressing your love

have who are fun to be with, teach us, and support us, the better off we are. ‘3 5 So, a large part of self-care is cultivating caring and supportive relationships. Mcleod & Mcleod (2014) also talk about the ill-effects of isolation. Therapists (especially those in private practice) may lack social support. Perhaps this is truer than ever during the lockdown experience! Many of us are lucky enough to have friends, colleagues and family with whom we can share our experiences. As professionals, dealing with vulnerable and fragile clients, we are also ethically responsible for the quality of our work.10- ln her excellent chapter (Carroll and Tholstrup ed 2001) Penny Henderson discusses supervision and the mental health of the counsellor. She explores aspects supervisors should be looking out for in their supervisees – such as evidence of motivation and resilience – and looks at how depletion may affect the counsellor’s professional work as well as her personal wellbeing. She suggests: • Regular reviews to explore motivation • Discussion of support the counsellor has, whether in the form of relationships or rewarding activities • Help to develop what she calls the ‘Velcro solution’, where our protective emotional layers can be removed for intimacy, but re-connected for resilience • Clarity about boundaries and limits If supervision doesn’t leave you feeling at least ‘restored’ (one of lnskipp and Proctor’s three functions of supervision11) or, preferably, energised, motivated and satisfied by what you do, perhaps you need to confront the question, ‘Why am I doing counselling?’ 4. Plan some changes! ‘Plan for your future because that is where you are going to spend the rest of your life’ (Mark Twain, quoted by Trevor Powell) Many of us continue along familiar pathways without ever stopping to think about whether we might benefit from doing things differently. Yes, sometimes fate intervenes, and yes, we live in the real world and there are bills to pay etc, but the fact is that in very many ways we choose where we are in life. When people say, ‘Oh, but we’ve got to work all these hours to pay the mortgage,’ I ask them why don’t they get a smaller house? There is a difference between need and want! To improve wellbeing, we must be absolutely clear about our priorities and commit to making any necessary changes. This sounds like hard work but often, when human beings are embarked on a path that feels right and exciting, they find ways of doing it, however demanding! (I have just been watching Captain Tom raising millions by walking round his garden at age 99!) If every journey begins with the first step we must stop prevaricating and make a plan! Some people like to do this formally, others work in a freer, more flexible way. Whichever you prefer, I suggest that the important elements of a manageable plan include: • Identify changes you would like to make (some people call these ‘goals’), from getting a comfier chair to moving to a different practice; from expressing your love more openly to volunteering. Remember to address all aspects of wellbeing, including physical, social, emotional and spiritual • Put them in order- maybe in terms of priorities or according to the time they need; or, to motivate you, start with something you can achieve fairly easily. If some 6 things appear too difficult, work out why {A SWOT analysis can help: see Mcleod and Mcleod 2011) • Research what you need: e.g. see what training is available or extend your network of contacts • Often, changes we make affect other people; think through any ‘sensitive’ conversations you may need to have Don’t spend too long on the planning- this may just be procrastination in disguise! 5. Starting today- do what you need to do! ‘Action may not bring happiness but there is no happiness without action’ (Benjamin Disraeli quoted by Trevor Powell) Look at your plans for each day, checking that there is a healthy balance; if there are lots of mundane things to do or if you have long working hours, structure your time: plan to punctuate activities with ‘wellbeing’ breaks – go out in the fresh air, have a cup of tea, listen to an uplifting song. Do the things you’ve planned! This is the most crucial stage. I see a lot of clients who have ideas about what they’d like to do, but they don’t seem able to get started. You need to be focussed and determined, and to think positively. In his book ‘Being Happy’, Andrew Matthews reminds us of the Henry Ford quote: ‘whether you think you will succeed or not, you are right’ (p 86) Recalling the growth mindset, remember that: ‘the most important thing is not the reaching of the goal but what we learn and how much we grow along the way’ (Matthews p 84) So, if things don’t turn out as expected, you may still make gains! Afterwards, reflect thoughtfully on what has happened: • List what went well and what you enjoyed • Examine how you made this happen • Be thankful for the good things in your day • Reward your successes and share them with someone who cares. A last word … I hope this has shown that all of us can, and must, do all we can to embrace a lifelong process of self-care which will be of benefit to ourselves, our clients and our loved ones. This is possibly the most important work any of us can do. And now I’ve finished this essay, I’m going out into the garden…

Refe re nces 1 ‘Helen’ q uoted in B u rn o ut . . . the high cost of caring ? The ra py Today, Nove m be r 2017: Vo l u m e 28, Issue 9 2 J u n e 14, 2019 i n Qua rtz at Work By Cassie Werber ( I nternet search) 3 See: M a s l a c h C. The cost of caring. Los Altos: M aj o r Books; 2015. 4 BACP https ://www .bacp.eo . u k/events-a nd-resou rces/eth ics-a n d-sta nda rds/good-practice-i nactio n/p u b l ications/gpia088-se lf-care-for-the-co unse11i ng-professio ns-fs/ 5 M cLeod a nd M c Leod 2011 p 57 7 6 The conce pt of a growth (as o p posed to fixed) m i ndset is the s u bj ect of ‘ M i ndset’ by Carol S. Dweck written in 2017 7 Trevor Powe l l , q u ot i n g Syd ney H a rris 8 See for exa m pl e ‘Cogn itive Thera py in a N utshe l l ‘ by D ryden a n d Neenan (SAG E 2006) 9 Ca rl Rogers fre q u e ntly wrote a bout he fu l l y functi o n i n g perso n, for exa m p l e in ‘On Beco m i ng a Person’ ( 1967) 10 BACP Ethical fra mework for the Cou nsel l i ng Professions states: We w i l l t a ke res p o ns i b i l ity fo r o u r own well being a s essent i a l to s usta i n i ng good practice by: a . ta king p recautions t o protect o u r own p hysica l safety b. m o nitoring o u r own psycho logica l a n d physical hea lth c. seeking p rofessi o n a l s u p port a nd servi ces a s the need a ri ses d . kee p i ng a healthy bala nce betwee n o u r work and othe r aspects of l ife 11 l nskipp and P roctor write extensively a bout s u p e rvision, e.g.in The Art, C raft a n d Ta sks of Counsel l i n g S u pe rvision (1993) a n d ident ify t h ree functions of s u p e rvision, viz Normative, Formative and Restorative Bibliography Bond T (200 1 ) Standards and Ethics for Counselling in Action ( London :Sage) Carro l l , M a n d Tholst r u p , M ( 2001 ed) Integrative Approaches to Supervision ( Lo n d o n : J KP ) Coo per, M : ( 2008) Essential Research Findings in Counselling and Psychotherapy ( Londo n : SAG E ) D u n nett, Jesper, O’ Donnel l a n d Va l l a nce (2013) Getting the Most from Supervision, ( Lo n d o n : P a lgrave M a cm i l l a n ) M atthews A ( 1998) Being Happy! ( S i nga pore: M e d i a M asters) M c Leod J o h n and M c Leod J u l i a ( 2014) Personal and Professional Development ( Be rks h i re : O U P ) M cLeod J o h n a nd M c Leod J u l ia ( 2 0 1 1 ) Counselling Skills ( Be rkshire: O U P ) Powell T (2003) The Men tal Health Handbook ( Oxford: Speech m a rk ) Sutton J a n d Stewa rt W (2008) L earning t o Counsel ( Oxford: H o w T o Books)