I first started seeing Mira* for burnout management at work. She was a psychologist herself and had found herself becoming increasingly tired and apathetic about her client work, and she was worried about what this meant.
She was visibly tearful in our first session. “This is all I’ve ever wanted to do. I don’t know why I feel this way,” she said.
As we unpacked her experience, we spoke about the structural forces affecting her work. Her daughter was a toddler, and she had also started taking on some caring responsibilities for her aging parents.
“I feel squished by everyone’s needs,” she said, poetically. We spoke about the difficulties of being a psychologist while also being in a caring role in her personal life: the exhausted empathy from sitting with intense distress daily, the profound fatigue after heavy sessions, the heavy administrative and compliance burdens, the anxiety about clients at risk, and the practical juggle of managing childcare and elder care around her client appointments.
As we spoke about Mira’s desire to leave the profession, she became very distressed. “This is all I know to do. This is the only thing that makes sense for me,” she said. She felt as though she had been immersed in learning about psychology from a very young age because her mother had experienced a significant episode of depression and had withdrawn almost completely from the family for months into her bedroom.
Mira took on the unnamed psychological task of trying to help her mother recover, and she buried any emotions she might have experienced in the activity-focused role of “being good and helping mum get better.” This was far beyond her developmental capacity and was a clear form of parentification, but it was the only control she had in a world that felt terrifying. These years set the psychological foundations for Mira to become a psychologist: an acute awareness of how devastating mental illness can be, an overdeveloped sense of responsibility and desire to help, self-sacrifice, and a tendency to intellectualize, such that her own emotions were processed cognitively rather than felt.
What initially felt like simple burnout was far deeper, and reflected the building blocks of self-sacrifice, over-control of her own emotions, and intellectualization that had been set in childhood. Her burnout was not confined to work, either. It showed up in her parenting, in her over-extension to support friends and family, and in the guilt she felt each time she stopped.
To treat her burnout successfully, we needed to look at these deeper patterns.
As I reviewed Mira’s case, I realized that most of my clients present in a similar manner. Each has an initial presenting problem, but almost always this problem is deeper than they realize and has its roots in patterns learned in childhood. These problems also appear across multiple domains of life (e.g., work, parenting, friendships, partnerships) rather than being restricted to one. In the burnout literature, I found that almost none of it focused on the early experiences that can set the foundations for burnout, such as why some people choose careers that are a poor temperamental fit, or why they may be driven to self-sacrifice even at risk to themselves.
My book, How We Relate, explores the building blocks laid down in childhood that give rise to so many common psychological difficulties, especially those that surface in our relationships.
Relationships are central to a good life, but we often forget that they extend beyond just the intimate and romantic. Also, we find it difficult to recognise patterns which show up across all our relationships — such as the way we navigate trust and closeness, how we respond to conflict, and how we navigate separations and pressure. Often, we don’t realise that there are patterns in our responses and behaviours that preclude us from taking action.
I wrote How We Relate to help us recognise, understand and change these patterns. By understanding the developmental origins of many of these building blocks, we can empower ourselves to truly understand how we relate to ourselves and others, enabling more trusting, open and satisfying relationships.
*all clients are fictional amalgams.