Latest / The Brain Dump / Therapist Burnout, Invisible Wins, and the One Thing That Keeps You in This Field | Episode 11

Transcript

Therapist Burnout, Invisible Wins, and the One Thing That Keeps You in This Field | Episode 11 · The Brain Dump

• 0:10
  SPEAKER_00: Hello, and welcome to the Brain Dump with Sandy Boone.
• 0:15
  SPEAKER_00: Today's episode is about the folder.
• 0:20
  SPEAKER_00: I want to tell you about a piece of paper I've had since graduate school.
• 0:25
  SPEAKER_00: It's not fancy, it's not laminated, it's a little worn at the edges, and at this point because I've pulled it out more times than I can count.
• 0:34
  SPEAKER_00: But I will tell you, that piece of paper has kept me in this field on some of the hardest days I've had as a therapist.
• 0:42
  SPEAKER_00: And here's how it came to be.
• 0:43
  SPEAKER_00: One of my professors in grad school did something I had never seen before and honestly haven't seen much since.
• 0:50
  SPEAKER_00: She had all of us write our names at the top of a piece of paper and pass it around the room.
• 0:55
  SPEAKER_00: Every single person in that class wrote something, something genuine, something kind, something they actually saw in you.
• 1:03
  SPEAKER_00: And then you got it back at the end.
• 1:06
  SPEAKER_00: And I remember sitting there reading what my classmates had written about me, and something happened in my chest that I didn't have language for at the time.
• 1:14
  SPEAKER_00: It was like, oh, this is who I am to other people.
• 1:19
  SPEAKER_00: This is what they see.
• 1:21
  SPEAKER_00: My professor told us to keep it.
• 1:23
  SPEAKER_00: She said, put it somewhere you can find it on the days that are hard, because the days will get hard, and you're going to need to be reminded of who you are and why you're here.
• 1:33
  SPEAKER_00: So, like the good student that I was, I kept it.
• 1:37
  SPEAKER_00: And y'all, she was not wrong.
• 1:39
  SPEAKER_00: I was recently sitting in a room full of students who are about to graduate and step into this field.
• 1:44
  SPEAKER_00: Brand new counselors, full of hope and nerves and all the things you feel right before you start doing the actual work.
• 1:51
  SPEAKER_00: And someone asked me, What do you wish you had known?
• 1:56
  SPEAKER_00: And I didn't have to think long.
• 1:58
  SPEAKER_00: I wish someone had told me how quickly mental health gets thrown under the bus when something goes wrong in the world.
• 2:04
  SPEAKER_00: And I wish someone had told me how rarely, startingly rarely, the wins get celebrated.
• 2:11
  SPEAKER_00: Because those two things together, that combination is what wears therapists down over time.
• 2:17
  SPEAKER_00: Not just the hard cases, not just the complex presentations or the ethical dilemmas or the paperwork, though all of that is real.
• 2:25
  SPEAKER_00: It's the constant experience of being in a field that only gets noticed when something has gone terribly visibly publicly wrong.
• 2:34
  SPEAKER_00: And if you've been in this work for any amount of time, you know exactly what I'm talking about.
• 2:39
  SPEAKER_00: Let's just say it plainly.
• 2:41
  SPEAKER_00: The only time mental health gets a seat at the national conversation table, the only time it trends, the only time politicians start making speeches about it is after a mass shooting.
• 2:52
  SPEAKER_00: And I want to be really clear about something because this matters.
• 2:56
  SPEAKER_00: The way mental health gets discussed in those moments does not help the people who are actually doing the brave, hard work of addressing their mental health.
• 3:05
  SPEAKER_00: It stigmatizes them.
• 3:06
  SPEAKER_00: It conflates getting help with being dangerous.
• 3:10
  SPEAKER_00: It takes something that is already difficult to talk about and makes it even harder.
• 3:15
  SPEAKER_00: And then, and this is the part that really gets me, we still cut the budgets.
• 3:20
  SPEAKER_00: We still underfund community mental health.
• 3:23
  SPEAKER_00: We still let insurance companies dictate care by reimbursing therapists at rates that haven't kept up with anything, while expecting us to carry full caseloads and provide gold standard treatment and oh, by the way, manage our own vicarious trauma on the side.
• 3:39
  SPEAKER_00: The message, whether anyone intends it or not, is mental health matters when it makes headlines.
• 3:45
  SPEAKER_00: The rest of the time, you're on your own.
• 3:48
  SPEAKER_00: That is the environment we are working in.
• 3:50
  SPEAKER_00: And if you're new to this field, I'm not telling you this to scare you.
• 3:53
  SPEAKER_00: I'm telling you this because nobody told me, and I think you deserve to go in with your eyes open.
• 3:59
  SPEAKER_00: Now let's talk about the other side of this: the wins that nobody sees.
• 4:03
  SPEAKER_00: Because therapy works.
• 4:05
  SPEAKER_00: I want to say that clearly and without hesitation.
• 4:08
  SPEAKER_00: Therapy works.
• 4:10
  SPEAKER_00: People heal, people change, people get their lives back.
• 4:14
  SPEAKER_00: I've watched it happen hundreds of times, and it still moves me, sometimes to tears.
• 4:19
  SPEAKER_00: But almost none of it is visible outside of the therapy room.
• 4:23
  SPEAKER_00: When a client has spent years living with trauma responses they didn't have language for, and one day they sit down across from you and say, I think I'm actually okay.
• 4:34
  SPEAKER_00: Nobody sends a press release, nobody gives you an award, nobody even knows it except the two of you.
• 4:40
  SPEAKER_00: When you figure out together that the anxiety your client has been white knuckling through for a decade or more is connected to a food sensitivity, when you put that together, when you help them understand the physiology of what's happening in their body, and they walk out of your office with a completely different understanding of themselves, that's extraordinary.
• 5:02
  SPEAKER_00: That is someone's life changing, and the world doesn't see it.
• 5:06
  SPEAKER_00: When a client finds their purpose, when they stop isolating, when they repair a relationship they thought was destroyed, when they stop medicating pain they didn't understand, and when they finally, finally feel like themselves again, that happens in your office, in your presence, because of work that you did together.
• 5:27
  SPEAKER_00: And then you close the door and you go see your next client.
• 5:31
  SPEAKER_00: There is no external scoreboard in this field.
• 5:33
  SPEAKER_00: There are no quarterly numbers to point to.
• 5:36
  SPEAKER_00: There's no moment where the world looks at you at what you did and says, well done.
• 5:41
  SPEAKER_00: And for a lot of therapists, especially early on, that absence of external validation is disorienting in a way they did not expect.
• 5:50
  SPEAKER_00: So when the hard days come and they will come, you have nothing to point to except what you carry with you, which is exactly why you need the folder.
• 6:00
  SPEAKER_00: So let me tell you what the folder actually is, because I want you to go build one after you finish listening to this.
• 6:06
  SPEAKER_00: The folder, mine is an actual physical folder, though it doesn't have to be, is where you keep the evidence.
• 6:13
  SPEAKER_00: The evidence that you're good at this, the evidence that it matters, the evidence on the days when you cannot feel it that what you do changes people's lives.
• 6:23
  SPEAKER_00: For me, it started with that piece of paper from grad school, the one my classmates wrote on.
• 6:28
  SPEAKER_00: I kept it because my professor told me to, and honestly, I'm not sure I fully understood why until a few years into practice when I had my first really hard stretch.
• 6:39
  SPEAKER_00: When I pulled it out and read it, I wasn't reading it as a grad student anymore.
• 6:43
  SPEAKER_00: I was reading it as someone who was tired and doubting herself, and it hit completely differently.
• 6:50
  SPEAKER_00: Those words, written by people who knew me before I had ever seen a client, before I had ever made a single clinical decision, reminded me of something I needed to hear.
• 7:01
  SPEAKER_00: That the qualities that made me good at this were already in me before I had any credentials.
• 7:06
  SPEAKER_00: Over the years, I've added to it.
• 7:09
  SPEAKER_00: Emails from clients who reached out after we finished working together, cards from people who wanted me to know that our what our work had meant to them, notes from students who told me something I said or did had changed how they thought about their work or themselves.
• 7:23
  SPEAKER_00: I keep all of it.
• 7:25
  SPEAKER_00: Not because I need constant reassurance.
• 7:27
  SPEAKER_00: This isn't about ego.
• 7:29
  SPEAKER_00: It's about the evidence-based survival in a field that does not hand you a lot of external mirrors.
• 7:34
  SPEAKER_00: Because there are going to be days in this work that are genuinely, deeply hard.
• 7:39
  SPEAKER_00: I'm talking about the days when you have to make a call to the Department of Social Services for a child welfare concern.
• 7:46
  SPEAKER_00: When you pick up that phone and report, knowing what that might set in motion for a family, holding the weight of all that responsibility, doing it anyway because it's the right thing to do, and you're ethically mandated to do it, that's not a small thing.
• 8:01
  SPEAKER_00: You carry that home.
• 8:03
  SPEAKER_00: There are days when a client is in so much pain that you have to refer them to a higher level of care.
• 8:08
  SPEAKER_00: When you help someone get to an intensive outpatient program, or when you facilitate an in-person admission and you did the right thing, you recognized what they needed and you advocated for it, but it doesn't feel like a win.
• 8:23
  SPEAKER_00: It feels heavy.
• 8:25
  SPEAKER_00: It feels like you wish you could have done more sooner, differently.
• 8:29
  SPEAKER_00: On those days, you need the folder.
• 8:32
  SPEAKER_00: Not because it fixes anything, not because it takes the weight away, but because it grounds you.
• 8:38
  SPEAKER_00: It reminds you of the whole picture when you can only see the one hard moment.
• 8:43
  SPEAKER_00: I want to talk to the therapist who've been doing this for a while, because maybe you had a folder once or something like it.
• 8:50
  SPEAKER_00: Maybe you had a reason you came into this work that felt clear and solid and true.
• 8:56
  SPEAKER_00: And somewhere along the way, without really noticing it happening, you let go of it.
• 9:01
  SPEAKER_00: Maybe it felt self-indulgent.
• 9:03
  SPEAKER_00: Maybe you got busy.
• 9:05
  SPEAKER_00: Maybe the days started blurring together and you stopped collecting the evidence because collecting it felt like it required more energy than you had.
• 9:13
  SPEAKER_00: I see you.
• 9:14
  SPEAKER_00: And I want to say it's not too late to start again.
• 9:18
  SPEAKER_00: Because the problem with losing your folder, whether it's literal or metaphorical, is that you start running on empty in a field that requires you to show up full.
• 9:27
  SPEAKER_00: And when there's nothing to refill you from the inside, you start looking for it in the wrong places, or you stop looking altogether.
• 9:34
  SPEAKER_00: And that's how burnout sneaks up on people who are genuinely excellent at what they do.
• 9:39
  SPEAKER_00: You didn't go into this work to survive it.
• 9:41
  SPEAKER_00: You went into it because it's something you believed it mattered.
• 9:44
  SPEAKER_00: The folder is just a way of keeping that belief somewhere you can touch it.
• 9:48
  SPEAKER_00: So here's the practical part, because I don't want to send you out of this episode without something actionable.
• 9:54
  SPEAKER_00: Start the folder today if you can.
• 9:58
  SPEAKER_00: This week, if today is too much.
• 10:00
  SPEAKER_00: Doesn't have to be physical, though there is something about a physical object that I personally find grounding.
• 10:06
  SPEAKER_00: It can be a folder in your email, a note on your phone, a document on your computer, whatever form makes sense for you where you actually are, and then start putting things in it.
• 10:17
  SPEAKER_00: If you have emails from clients you've kept, go find them and put them there.
• 10:22
  SPEAKER_00: If you have a card on your desk that you always mean to do something with, put it in the folder.
• 10:27
  SPEAKER_00: If there's a note from a supervisor or a colleague that reminded you of something true about yourself, put it in the folder.
• 10:35
  SPEAKER_00: And then do something my professor told me to do.
• 10:38
  SPEAKER_00: Make it findable.
• 10:40
  SPEAKER_00: Put it somewhere you can get to it on the days when you need it.
• 10:43
  SPEAKER_00: Because on those days, you're not going to have the bandwidth to search.
• 10:47
  SPEAKER_00: And here's my one other request.
• 10:49
  SPEAKER_00: If you are ever in a position to do what my professor did, please do it.
• 10:54
  SPEAKER_00: Pass a piece of paper around a room and let people write on it.
• 10:58
  SPEAKER_00: Tell your students or your interns or your colleagues what you genuinely see in them.
• 11:04
  SPEAKER_00: Because that piece of paper has been in my folder for a long time, and it's done more for my staying power in this field than any training I have ever attended.
• 11:13
  SPEAKER_00: This field is hard.
• 11:15
  SPEAKER_00: I'm not going to pretend otherwise.
• 11:17
  SPEAKER_00: It is hard in ways that are not visible, and it's lonely in ways that can be surprising.
• 11:24
  SPEAKER_00: You will carry things home that you cannot talk about.
• 11:27
  SPEAKER_00: You will celebrate wins that nobody else will see.
• 11:30
  SPEAKER_00: You will have days that test everything you have.
• 11:33
  SPEAKER_00: And you will also change people's lives quietly, consistently, in rooms that the world never sees.
• 11:41
  SPEAKER_00: You will be the person someone trusted when they couldn't trust anyone else.
• 11:45
  SPEAKER_00: You will hold things that were not okay and help them become something more bearable and then something more than bearable.
• 11:53
  SPEAKER_00: That matters.
• 11:55
  SPEAKER_00: All of it matters.
• 11:57
  SPEAKER_00: Keep the folder, add to it, pull it out when you need it.
• 12:01
  SPEAKER_00: And on the hard days, which will come for all of us, remember that the wins are real even when no one is celebrating them.
• 12:09
  SPEAKER_00: Especially then.
• 12:11
  SPEAKER_00: If this resonated with you, this is the kind of conversation I care deeply about.
• 12:15
  SPEAKER_00: The real stuff that doesn't always make it to supervision or continuing education.
• 12:20
  SPEAKER_00: The human side of doing this work sustainably.
• 12:23
  SPEAKER_00: If you're a therapist who's also curious about building a coaching or consulting practice alongside your clinical work, or if you want to explore tools like neurofeedback that can shift the way you support your clients, I'd love to talk.
• 12:35
  SPEAKER_00: Thanks for being here.