Recognizing the Hazards (Chapter 3)

Leaving It At The Office

One-way Intimacy	“The client is asked to share herself in great detail, while the clinician responds with little disclosure.” (p. 40)
Burnout	“Physical and emotional exhaustion, involving the development of negative self-concept, negative job attitudes, and loss of concern and feelings for clients.” (p. 56)
Wearout/Brownout	When “a practitioner essentially gives up or performs in a perfunctory manner when confronted with too much stress and too little gratification.” (p. 56)
Classic/Frenetic Burnout	When a “practitioner works increasingly hard to the point of exhaustion in pursuit of sufficient gratification to match the extent of stress experienced.” (p.56)
Underchallenged Burnout	When “a practitioner is not faced with work overload but rather with monotonous and unstimulating work that fails to provide sufficient rewards.” (p. 56)
Transient Difficulties	Professional difficulties arising from competency deficits
Paradigmatic Difficulties	Professional difficulties stemming from therapists’ personality
Situational Difficulties	Difficulties stemming from patients and circumstances

Two of the most common hazards of our profession are the uncertainty and lack of success.
Major burdens include physical isolation (e.g., sedentary job, lack of contact with the world and non-clients), emotional isolation (e.g., one-way intimacy, inevitability of termination, confidentiality), patient behaviors (e.g., aggression, premature termination, suicide, malpractice), working conditions (e.g., onerous paperwork, high expectations), therapeutic relationships (e.g., responsibility, over-involvement), and the industrialization of mental health (e.g., decreased freedom).
It is challenging to “turn off” the therapist role when not in the office. Further, therapists may struggle to reach out to make emotional contact with loved ones. Why do you think this is?
Therapist empathy is curative for the client and harmful for the therapist. How can we balance openness to client feelings with the need to preserve the self?
We are the tools of our trade. Psychotherapy can lead us to become “dull, chipped, or broken” if we do not take appropriate care of ourselves.
Caring for oneself can incorporate recognizing the hazards, accepting the hazards, having self-empathy, using team approaches, and tailoring the care to our personal needs.
Therapy is a job where we gain much but at a potentially high price.