When the flame burns out

Helping others has been instilled within me as a person from a young age. I grew up watching my Mom work long hours in the ICU, helping patients battle and recover from illness. I watched my Dad keep close contact with relatives and ensure family connection was present with helping them with doctor’s appointments, regularly visiting in nursing homes, and simply doing for others before thinking of themselves. As humans, helping others can be an extremely rewarding and fulfilling commitment and we often want to help those in need because it generally makes us feel pretty damn happy.

I’ve always been fairly in tune with my emotions, reading body language and reading how others are feeling given different situations and circumstances. In junior and senior high, I tried to be there for a number of my friends on a regular basis, for emotional support, help with school subjects, relationships, etc. I placed a high value on being a good friend to a lot of people and often took on a number of other people’s issues and problems, and tried to help them process and provide advice where needed. I loved it and it felt really good to give back and talk about similar issues that we were experiencing. Pushing myself out of my comfort zone with social relationships and conversations provided opportunity to have meaningful conversations with others and create solid friendships that I still hold close today.

Transitioning on to university, these ideas of pushing myself to be the “best” person, friend, student, and employee always came to the forefront early on and didn’t slow down. If a friend was upset, well I should be there to console them and take on the burden. If a friend has been hurt emotionally from a bad night out at the bar, well I’ll take on that as well. Let’s throw in a break up. Bad marks on a test. Fines from huge parties, etc. Get involved as much as possible. Volunteer opportunity. Sure. Tuesday, Thursday. Saturday. Yep. Sure let’s do it. Societies. Yep I’ll try that out. Early on at Acadia University, in addition to the normal pressures of excelling, I set a foundation of “success” for myself in doing as much as I possibly could, in the shortest periods of time, so that I’d feel accomplished.

I arrived at Dalhousie University in the fall of 2013 to start my masters, and I didn’t stop there. No no, I took it all on. Cautions from others of pacing myself, and making sure I make time for myself. I’m a naturally social extroverted introvert and I love being around people, so doing as much as I could helped my mind be comfortable to feel connected to my classmates and build on the new friendships I had. I wanted to make new connections and learn from the professors and instructors. And again throughout my 2 years there, took on every possible volunteer and extracurricular I could handle. They were new opportunities, presented a new challenge for learning. In my second year, in addition to heavy neuroscience and research based coursework, I helped organize and run orientation week for the new incoming class, helped organize and DJ our OT ball, and on the committee for a health professional benefit supporting a local charity called “For The Health of It.” One of my best friends and I created a Lip Sync Challenge for our school and with the help of many raised over $5000.00 in one night in support of the local charity. Intramurals - let’s try as many as possible. Volleyball, Basketball, Flag Football. Let’s do it. Late nights of studying to cram as much of the brain and spinal cord information into my own brain, finishing research papers, and learning some pharmacology along the way.

For years, I had been pushing myself to overload, all the time, for the perceived ideal of giving to those, before you taking care of myself. As the month’s progressed, into my final two placements for school, and heading into my final 6 weeks at school, anxiety and depression started to set in real time. What now? What do I do next? All of my opportunity to take on the most is gone. I have time to relax and work one job instead of seven? My heart wanted a yes, but my brain had trained for this. High octane. We got this big guy. Let’s go.

After graduating from my masters, many know that my first job was not my ideal occupation, and I added in more and more. I continued my work in supportive housing to try and fill the void of missing friends from school, loneliness of living by myself and with a close friend until I could get on my feet. Exhaustion. Poor eating habits. Chain smoking Canadian Classic Silvers to pass that next 5 minutes of hell. Depression. Anxiety. Panic attacks. Unmotivated to even get out of bed. And while you may be aware of what happened next, pushing myself to my limits had finally caught up with me, and it broke me down to my supposed last days.

After coming off of short term disability, I built some endurance back up to return to work for a month or so, before interviewing and accepting the position at Dalhousie University. I was yet again presented with new challenges that were again absolutely meaningful to me, to be able to teach, help guide and interact with people and students again. Learning from and working with exceptional academics and instructors, running labs with students and supervising students on fieldwork. A dream come true. Matt, do you think you could do this? Trained Brain of Giving kicks in. Well hell yes exhibit A we sure can, what do you need us to do? MC a sold out Rebecca Cohn fundraising event? Sure I’ll take that on. Continue support 6 men in supportive housing on a weekly basis? Yep let’s do it. And the cycle started over again. Taking on as much as possible to fulfill the centres of my mind that were convinced early on that if I keep giving myself, good things will come.

After my contract ended at Dalhousie University, I moved west to British Columbia for the job I’m still in today. A new job, a new start, a new opportunity. New clients, new area of occupational therapy. Thrown in right away, working away, accepting as much work as I could to help kids in need and the company out that I just started at. Proving myself, to myself yet again that was the only person that actually thought that this unattainable goal of perfection via hard work and giving endlessly, at the sacrifice of whatever impact it had on me. And I fell again. Panic attacks, severe anxiety, exhaustion, depressed to the nines, impossibility of catching up with initial assessments, feeling like I was actually doing a good job, melting down at home and at work. Pure mental decline. Years and years of endlessly giving my full self for anyone who needed it, and taking on any and every emotion of coworkers, parents, and clients as if it was a reflection of something I had done wrong. I was done yet again. Barely functioning on the inside, with hiding everything on the outside. Suicidal ideation always creeping back around, calling in sick at work, cancelling days because I simply couldn’t deal. A hole that felt as though impossible to climb out of. I had burned out for the last time.

Burnout has been a massive contributing factor to my challenges with mental illness over the years and  a cycle that had been subconsciously building for years without me being the slightest bit aware. Burnout is job related and can be defined as “a state of physical or emotional exhaustion that also involves a sense of reduced accomplishment and loss of personal identity.” Bam. Mix in 2 oz’s of perfectionism, 3 oz of shame, lemon wedge of anxiety, and a dash of major depression. Well there you have one hell of a fucking cocktail for disaster.

Burnout can happen to anyone, in a variety of ways if there’s continuous high stress and job demands. And while I can’t speak to other professions in likely knowing some may feel the same, I can speak to being a healthcare professional and how it’s so easy for it to happen over and over again. People have different views on why they get into healthcare, but at the foundational core is that one likely wants to develop both their current and learn new skills to help people get better, recover from illness and disease, and cope with current conditions. As healthcare professionals we have systemic pressures for job demands and deadlines, seeing patients and clients on a regular daily basis, and endless amounts of paperwork and documentation. We want to help, over and over again, at the sacrifice of our own health. And if you don’t have the skills to combat burnout, as evidenced above with what I lived with for years, it can take over your life, and make you believe that you’re worthless, that you could never be the professional you imagined, and rip every piece of motivation away. Emotionally barren and minimal physical capability of borderline function.

Burnout is so very real and it’s a nasty cycle that I finally decided to get some help with. About 6 months into my new job here in BC, I had finally gotten ahold of my caseload, the new job, my clients, and continued to take on more and more. Until I broke and called my therapist for an emergency session. A week straight of panic attacks, minimal sleep, worrying about the next day’s assessments, the notes, cleaning, prep. And I had hit the millionth breaking point and asking what I needed to do. I knew I couldn’t keep going on the way I was, and although the suggestions and ideas I worked through in therapy were quite simple in nature, they were the biggest mountains I had to climb along my journey. And while these mountains did take quite a while to climb, they’ve really helped me become a healthier Matt and I’m really pleased with the results.

Here are three strategies that I’ve directly applied in and out of therapy that have helped me fight burnout this past year :

1)      “If it does not serve me, I will let that shit go.”

Being an empath, I had always taken on others issues as my own for years and it relates back to early on in school, and wanting to be the problem solver for so many. I committed to being there for so many people emotionally that I lost my identification of how I might be feeling, and making sure that I made space for me to feel the way I did. During my first year in BC, I took on frustrations from parents with the systems in place for their children’s services personally, tip toed around some coworkers, while taking on issues of others as my own, and taking rough days as somehow being my own fault. I took other’s bad days as mine too, and eventually it brought me to a point of dreading interactions with certain parents, and with certain clients because I attributed their struggles as having to be my own. My therapist always writes me some notes on a note card and at the end of one session closing in on the ¾ mark of year one, the final sentence read, “If it does not serve me, I will let that shit go.”

Something clicked that day, and while it wasn’t immediate, I started to take a step back as a therapist and thought about how I could make myself equally as effective, without taking everything on. And I did this a couple ways (the second of which I’ll talk about in the next section). The first was to remove myself from the be all, end all position in the therapeutic relationship, and placed myself beside my clients to be there as part of their journey, the way it’s supposed to be. It’s so easy as a therapist and person to get caught up and want to be perfect and be the best all of the time, being able to solve all of the problems in the world, at the snap of the finger. Taking on other’s problems and bad days. This was the first area I started working on and applying in my life at work and it started working. I’m really proud of myself in how far I’ve come when it comes to not allowing others to dictate how I’m going to feel on a day to day basis. Just an active repetition of self reflection, thinking logically about the vast array of emotions presented to me on a daily basis from clients and some parents, and over and over thought: Is this frustration with the current systems or admin a reflection of the hard work that I put in day in and day out? No. It’s not. And I’ve kept that up to present time and continue to practice this idea, that these feelings that others might have on a certain day, time, etc. Are likely not even close to being a reflection of my effort, time, skills, and capability as a therapist. So I stopped letting those feelings in as much, took a different perspective, and applied it. Of course, some stuff can trickle back in some weeks, but I’ve improved so much by paying more attention to what serves me well emotionally vs what does not and thinking logically about others feelings.

2)      Setting Boundaries: Employers, Coworkers, and Clients

This is the hardest part of the work I’ve done to develop new communication skills and battle burning out. For months my therapist was introducing and presenting ideas of setting boundaries at work with the issues I was having with my work schedule, client caseload, inter professional communications, and with some families taking advantage of me, talking down to me, and coming at me when all I was doing was trying to help. I don’t blame any of the lack of boundaries being set on anyone. I don’t even blame myself. I just acknowledged that this was something that I needed to do for me. I love my job. I love my clients and families. I have great working relationships with my bosses and admin, coworkers, etc.

Boundaries are an essential part of effective working and professional relationships, and if you haven’t established them, you can end up feeling like you’re out of control, that you can’t accomplish what you want to, and ultimately lead to burning out. To me, boundaries are identified limits of what you will and will not do and both identifying and communicating positive and negative consequences of not abiding by these limits to one or more parties. So for me, I started with sitting down with my bosses and telling them about what had been going on mentally and coming clean. We came up with a tentative plan, brought in the right staff to help, and supported me to getting back to where I wanted to be. In that meeting I told them what I wanted, what I couldn’t do anymore, that I was willing to work with them on it, and that I needed help. And they’ve really came through for me in supporting me as a therapist in what I need. I’ve continued to be a strong communicator at work, and when I need something to change, or have problems, I go to them for advice and support.

Employers, bosses, and management can’t help you until you bring concerns forward. Complaining to coworkers, keeping everything bottled up inside, and convincing yourself of other stories is all fine and dandy, but they’re people too, and they can’t read minds. So, schedule a meeting, pull them aside, and talk to them about what’s going on. Ask for help. I promise you, the good bosses, and the ones that care, will help you the best they can. They want to see you succeed. And in situations where that boss doesn’t, I think it’s okay to start thinking about section one, and asking yourself, does this serve me any longer? If it does, then that’s good and carry on. If it doesn’t, don’t be afraid to stand up for your health and well being.

Setting boundaries with coworkers, clients and families were much of the same principles. Phone calls, family meetings, staff meetings, side 1 on 1 meetings. Here’s what I’m willing to do. Here’s what I’m not willing to do. I will be here to support you, but this is what I need from you in return, and if you can’t do that, then it’s okay for us to part ways. I was in the arena with the hectic schedule, endless prep and documentation. I took control of my arena again and it felt really fucking great. No disrespect. No judging. No budging. This was for me, and I needed this.

And I haven’t looked back since. Clear expectations of what you will and will not do. That you are here to support and do your work, but you too have boundaries that you will not compromise on. And if these are not respected and valued, I will walk away.

3)      Listen to your body and get back to loving you.

As mentioned above, burnout turns us away from emotional and physical stability and can often times push us into chaos. For years I accepted endless amounts of work that were less meaningful to me than to others, to propel myself into success and worthiness, all the time losing connection to my identity as a person, health professional, and partner. High stress work can only be tolerated for so long by our bodies. Our minds may travel to thinking that living at high velocity is the new normal for so many years, when in reality it’s likely contributing to eventual destruction and self loathing. Early on in counselling and really until this day my therapist has been consistent in giving me space to be vulnerable with the idea of listening to my anxiety, thoughts and feelings, and making sure that I create space for doing what I, Matt, loves to do. With being in a safe space for being with my thoughts and challenging, thinking with, and asking why they were there – I was able to identify that my anxiety is telling me things. My anxiety is telling me I need to slow down, and that I’m overwhelmed. That when it’s present, it’s there for a reason and not just because I have it. That my longing to be perfect really wants me to protect me from being vulnerable. That my depression seeps in when my deep relationship with shame comes to the forefront and all I want to do is give up. I started these conversations with my feelings and emotions and tackling why they were present. It’s given me such greater insight to identify early signs of burnout, and I’m now able to catch it in the early stages. It’s been quite fascinating to look at myself from the inside out, and combat burnout with engaging with my mind on a deeper level.

The second piece is getting back to loving you. Overloading yourself with things, work, friendships, commitments is exhausting and with high stress, high demand work we can lose ourselves and our identities with what we love doing, what brings meaning to our daily lives, and what actually matters. For the longest time I was so caught up with what I thought other people wanted me to do, as compared to what I actually wanted to do and enjoyed doing. So I took a stand on what served me well and got back to doing what I knew was great for my mental health. I started running and getting back to the gym and working on creating a better headspace for not only being at work, but creating a new relationship with my body and how I felt about myself. I got back to playing golf regularly, with good friends and good company. I focused on the relationships that brought positivity into my life, that pushed me to be better, and let the ones that did not serve me any longer fall to the wayside. I got back to doing the things that made me feel like Matt again. I started loving myself again. I started taking my therapists’ consistent recommendation of showing myself compassion on the hard days. I started believing in myself for the hard work I’m doing and the investment I’m making for my future as a husband, as a father, and hopeful role model.

Burning out, over and over again becomes subconsciously addictive and habitual if we let it continue on. The key point that I’ve had a hard time accepting and working towards believing is that what I do is enough, and giving until I can’t give anymore is detrimental to my health and doesn’t productively serve anyone in my life, other than trying to be perfect. And by no means do I think that burnout, or depression, or anxiety won’t try to creep back in, in the future. In fact, they do most days and weeks. However with all of the work that I’ve completed in my sessions, and direct application of tools, strategies and ideas to try in and out of work, I’m moving forward in a positive light. I’m excited for a future of endless opportunities, with peaks and valleys, and an eternal flame that will never burn out again.