Defending Against Our Own Needs: Reflections on Burnout

February 11, 2010

By Jeanne Denney

 It has been about ten months since I made plans to start the Kairos Network and Project to study and address needs of people who give care to others.  It was an experiment.   I started the Network for death and dying professionals  after having a good experience in  a regional birth professionals Network here in New York called Birthnet.  Birthnet is a good natured sisterhood that has been around for years advocating for natural birth.  It now functions mainly as an online  group for referrals, information, networking and support.   It demands nothing but a small yearly membership and is a place one can go after supporting a bad birth experience to process and regroup, to find out about an M.D.’s birth practices, or the herbs for pregnancy ailments.   It was so clearly a model of positive support,  I thought that the value of connections between death professionals would be self-evident to those who work the other end of life.  Having worked one year as a spiritual care coordinator at a hospice, I knew something about the needs.

Death and eldercare workers are busy and often tired.  Trying to offer something as undemanding as possible, I first established an internet group that required no face time or money and asked friends and colleagues to join as a simple experiment in the value of connection.   I got about ten no’s to each yes, for a long time getting only no’s.   I was overwhelmed by reluctance.   Here is a sampling of responses:  “I am just too busy to add anything else in my life.”  “I don’t need to connect with co-workers, I have my family.”  “I just don’t want to talk or read about this stuff after work hours.”  “I do enough.”  “When I am not working I want to think of something else.” “Maybe later.”  I realized that I was talking with people who were probably overwhelmed and had an image and experience of connection as a thing that necessarily depletes, rather than renews.   

As the data from my first naïve experiment came back, I was filled with new questions.  Was there really no need for support and connection?   It certainly didn’t seem that way to me from the conversations I continued to have with friends and colleagues in the field. Surely I made errors in process and my intentions may have been hard to understand.  Surely there is a sacred right to say no.   But was that all that was going on?  Had I done something foolish, inappropriate, embarrassing or ill-conceived?  Did this have to do with the stigma of offering something free in a culture of seduction and betrayal?  Fear of groups? The refusal to eat of the starving?  The blithe indifference to self-preservation of the hypothermic?   Are death and dying workers fundamentally so different from birth doulas?  And finally, did it really have to be this way?  

The Upfront Cost of offering Free Hugs

Reviewing these questions in these ten months I have to notice how often I have felt remarkably isolated despite my strong intention not to do it alone.   I felt much like I do walking into a room to offer support to an angry or unreceptive person at end of life.   I had to reflect on how difficult it is to bring the idea of connection as a net positive when there has been a history of disappointment,  and to be fully present with both misunderstanding and rejection.  Like Juan Mann in the Free Hugs video, what I hoped to bring to others through simple connection has most often been feared as an inappropriate demand on limited resources.  I too became familiar with the look of “what weird thing do you want from me?” when the answer, had the question been asked, would only have been “to make connection” “to give and receive” “to co-create” or “to explore the power of the heart to change both of us and our work.”  Indeed, these days that may be weird.  The overwhelming response brought me, like Juan Mann, to my first learning:  Opening  even small opportunities for heart connection in places where it is not usually present brings up things for people.  Doing it without enough support is risky.

Unpacking the mystery of indifference

I probably would have taken this all as a personal failure had I not been familiar with research on compassion fatigue, burnout and vicarious  trauma.   Though I may have been naive, I also understood that, just as my colleagues were being affected by the traumas of the people they were touching without adequate support, I was beginning to experience vicarious trauma by offering to touch the pain of  their caregiving as well. 

Fortunately, having studied body psychotherapy, I also understand some of the origins of this problem in our body, energy system and our human development.  Many of us become caregivers because we did not ourselves receive adequate care in early development.  We became especially sensitized to the problem of needs of others and took a deep vow very young to meet them at all costs, to be a really “good giver”.  At the same time, we were usually equipped with a relatively weak experience of receiving deeply ourselves and a damaged self-care low fuel alarm that seldom registers “empty” until our resentment makes us ready to kill.  It is likely that we learned to defend against the voice of our own needs as if it was an inner enemy.  Later we present as needless, appropriate and efficient.  “What me need?  I don’t need anything.  I am a good giver.” (Not a bad, vulnerable, needy receiver).  Of course this is my own story as well. In most cases, this split and heartbreak was also shared by our primary caregiver.   

Unfortunately the imbalance of our young responses to needing sets us up for caregiver burnout, a pattern that needs conscious adult re-patterning so that we can truly receive the joys of our work.  To quote writers Grosch and Olsen  “The hunger for mirroring and the inability to find it in many work environments are the primary causes of burnout” (When Helping Starts to Hurt, 1994). 

 What are some of the most effective ways of re-patterning this?  Alas, one big one is creating community with others who do similar work, supporting the task of finding meaning and pleasure .   Others are finding venues for respect, recognition, and sources of needed information.  Another is the speaking and hearing of our work stories.  Others are creativity and body awareness.  Measures such as these support clarity, renewed energy and meaning, even though initially, yes, they seem like just more things to do.

Admittedly Kairos has had a timid beginning.  But it has begun, thanks to a few fearless friends willing to contribute, engage with me, listen, help me laugh and be excited.    I have to remind myself that a principle of Kairos that interested me from the beginning was the idea of allowing things to unfold from intentionality, rather than forcing with an imbalance of will, allowing myself not to lead in an ordinary way but by making mistakes and “learning with”.   That this project began through an enactment of my own issues, indeed the very issue it seeks to be with has made me laugh.  This form of creation may have a more meandering and uncertain course.  I am not able to control its process.  Yet this is the way of the heart as I understand it. 

I am still here and feeling better now that I have openly reflected on my own experience.  I am still interested in creating safe haven for heart work in concert with others.  I am still willing to hold space for change with the optimism of a sign that says “Free Hugs”.  Saying no is always respected.   Still, saying yes is so much more interesting.

Jeanne Denney is a therapist and hospice worker in Rockland County, NY.  She directs the Rockland Institute for Mind/Body Education and Kairos, an organization for helping professionals. If you are a caregiver interested in joining the Kairos Network, just send her an email. jeannedenney@gmail.com

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6 Responses to “Defending Against Our Own Needs: Reflections on Burnout”

  1. Sandra Haviland said

    Hi Jeanne,

    I just wanted to take a few moments to offer you a heartfelt thank you for writing such a moving piece about your (understandable) frustrations/hopes/& highest intentions for creating community/support
    a network of open hearts and engaging minds …as well as your growing sense of disappointment/vul- nerability/nagging questions and/or doubts about the process.

    It must be incredibly difficult (even as it is exciting and inspiring!)to birth such a provocative and beautiful concept/resource for drawing people together in this kind of forum to share/learn and ‘connect’ with one another…in hopes of energizing affirming/and stirring the pot of our intellectual emotional and spiritual wisdom as we share and/or respond to the many layers of issues/experiences and feelings that surround the death/dying and eldercare work that we all do in one capacity or another.

    I commend you and uphold you for what has surely
    been a huge and generous undertaking to create this site for us …and offer so many resources (besides the opportunity to interface with one another via the written word!) and yet, to have only a modest trickle of voices offering remarks here and there.
    I am certainly among the ‘trickle’. I also probably represent some of those you referred to who are often tired and/or overwhelmed by the many demands of their personal and professional lives.

    For me…at this particular time ..I am constantly dividing my time between two different worlds… that of an interfaith seminary student …and that of a chaplain intern in a nearby teaching hospital.
    I also volunteer as a Reiki practitioner in a nearby hospice whenever time and energy permits.

    Obviously, the latter two settings bring me into
    direct contact with death and dying issues. In the hospital …where I am often called in to offer prayers/and/or spiritual support for someone who is actively dying …or has already died …or is about to be taken off life support etc. I work with the families as well as the patients …and yes, it can be very emotionally draining work.

    However …we (chaplain interns) also have the
    benefit of daily debriefing sessions when we all
    gather together in a private conference room at the end of the day & ‘talk about’ and/or process our experiences in an extremely supportive environ- ment. This has been enormously helpful in bringing to the surface what otherwise might end up being stored within our interior landscapes …and eventually lead to ‘burn out’ fatigue/spiritual depletion issues etc.

    My work in Hospice however …where I come in (by myself) solely for the purpose of offering energy work (body/mind and spirit) for both end of life patients …as well as their families and usually at least one or two staff members will take advan- tage of my presence and enjoy a deeply soothing, emotionally and physically restorative Reiki treatment …I myself …have little opportunity
    to process my experiences in dealing directly with dying patients …in such a physically and spiritually intimate way …beyond sharing an
    experience or two with my husband …or another family member. And so …to have a forum that I could come to and share experiences/insights/left over questions/musings of the soul etc is indeed a very appealing concept.

    And yet …like so many others …issues of time and energy are a constant theme in my life. I for one find ‘nature’ walks to be an incredibly powerful resource for physically and spiritually ‘re-fueling’ after such intense encounters …I also love to write …(and yet ..I write and study voraciously every week relating to my seminary
    program!)

    And so …none of this is probably very helpful or encouraging to you …no doubt everyone has plenty of ‘reasons’ why THIS particular resource community has not yet become more of an automatic ‘go to’ place for interfacing and supporting one another.

    I suspect its primarily ‘time’ and ‘energy’ issues with the added challenge of not really ‘knowing’
    others in the group well enough to feel motivated (and for some …comfortable) enough to share whats most deeply on their hearts relating to this kind of work. You also (most generously!) include all kinds of other posts to read and respond to …but again …while some might be drawn to political and/or social activism pieces about this or that.. others …(like myself) might be more drawn to
    the articles (and magazines which I have already
    invested in through this site!!)like “Bridges” … and/or the ISSSEEM(International Society for the Study of Subtle Energies & Energy Medicine)to find out whats going on currently in this field. As a Reiki practitioner …this has been an absolute treasure to come across …and I “thank you” for including it as a resource in this intellectually and spiritually rich and stimulating reservoir of possibilities for growth/enrichment/connection etc.

    Well …I’m afraid I’ve babbled on way too long, but I felt as though you were reaching out to all of us for some kind of significant feedback. I hope this will provide you with just a small glimpse into some of the issues that ‘some’ of us ..or at least ME …face with regard to active partici-pation in this site. I do think it has the potential to keep growing ..and I do hope to make more of an effort to contribute my own 2 cents in the future. I also sincerely thank you Jeanne for all that you do ..and all that you are …and all that you provide us with in this amazing network
    of people and resources …this place you call Kairos …a beautiful and perfect name, indeed.

    Namaste Sandra

    • Hi Sandra,

      Thanks for this. I hoped I would not elicit guilt as I described my own process of engagement. I certainly did not think of you as a person who was uninvolved or unsupportive, as most of this story was well before you were involved. I just wanted to openly share my process, itself instructive I hoped, and bring the whole issue for examination. Many people do not have the venues you have in end of life care, and if they do, avoid them. It is an interesting problem. My point: Let’s start talking about ambivalence to connection.

      Your experiences, questions and comments on your Reiki experiences would always be welcome in the network. And truly there is no performance pressure, only an opportunity.

      Thanks again.

  2. Susan O' said

    Jeanne,

    Your description of your process and experience comes at a good time for me as I find an unusual constellation of people close to me in painful and challenging life situations revolving around injury and death. The process of working within these experiences is complex and I am grateful for your heart and energy that enabled you to proceed with this ‘experiment.’

    For me personal grief can be silent and private and yet I know that when I allow community support into my process it is most beneficial. Just as when I read your blog. It felt as if a chip of ice were melting within me as I remembered the shared experiences and struggles we all face.

    Blessings,
    Susan

  3. Nathan S said

    Thanks for this. I especially resonated with:

    “Many of us become caregivers because we did not ourselves receive adequate care in early development. We become especially sensitized to the problem of needs of others and take a deep vow very young to meet them at all costs, to be a really “good giver”. At the same time, we are equipped with a relatively weak experience of receiving deeply ourselves and often have a damaged self-care “alarm system” that never registers “empty” until our resentment makes us ready to kill. It is likely that we learned to defend against the voice of our own needs as if it was an inner enemy. Later we present as needless, appropriate and efficient. “What me need? I don’t need anything. I am a good giver.” (Not a bad, vulnerable, needy receiver). In most cases, this split and heartbreak was also shared by our primary caregiver. The imbalance of our young responses to needing sets us up for caregiver burnout, a pattern that needs conscious adult re-patterning so that we can truly receive the joys of our work.”

    -Nathan

  4. I am retired and in the beginning, I was young enough to volunteer for many causes. As I get older, I have to devote more time to me and less in giving to others. I too was in the field of death and dying. Both as a professional and in experiencing many losses myself.
    I also do “Laughter Exercises” to groups involved in this as well as a relaxation and visulazation program. THose keep me sane.
    I welcome any physical touch including hugs. I also can empathize with anyone who is facing death, and understand families in crisis with the loss of a loved one.
    My friend just lost her husband of 54 years very recently. The pain for her is unbearable. I give her whatever support I can, however, she is in the acute mourning phase, and there is nothing she will accept that I have to offer her. All I can do is stand by and wait for her to be ready to move on.
    I think that is the crux of the problem why most people are not willing to engage in help not sought.
    I hope this might be help ful to you.
    Although my volunteer days are mostly over, I would be interested in hearing from Kairos. As you can see, it’s very hard for me to say no.
    Thelma Miller

  5. jim evers said

    Jeanne, I understand what you are saying and I empathize with what you are feeling, having had similar feelings for one or two of my attempted projects. But more than that, I commend you for carrying one, especially as you expressed that in your last paragraph. I know that you are fully aware of (as you say) “compassion fatigue, burnout and vicarious trauma.” The need for support certainly exits, but to get people to avail themselves of support services is often difficult. Possibly if you posted an anonymous story of some caregiver who benefited from your support or from a similar such support, that might start a small snowballing effect that could gather momentum. My best wishes are with you.

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