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3/5/2022 Psychological Change Management Most people first come to counselling with a specific issue in mind, often something like not feeling able to manage work as well as they used to, a problem with relationships, or stress. It’s possible to do solid work which results in a helpful goal becoming more clear and therefore more achievable in around 6 weeks. Very often, that’s how coaches approach their work and, in repeating that cycle with the same client and a different goal a number of times, they can get real insight into the client’s life which allows them to speed up the goal-identifying and achieving process. Counselling has been moved into a goal identifying and achieving role over the last decade or so and for some people that’s fine. It’s called ‘solution focussed counselling’, usually 6 or so sessions long and you’ll access it through most Employee Assistance Programmes (EAP’s) your GP and some counselling agencies. It seems an obvious choice when you compare it to what Hannah Booth writes about - a decade of more or less weekly meetings all of which must be paid for in money, time and emotional investment. Life is not always easy, there are things we all have to do that we would rather not do, things outside of our control change our lives in ways we can’t predict, events that we plan for knowing that they will cause disruption, even chaos, suddenly veer out of our hands. Coaching and solution-based counselling can help bring structure to managing these events. Longer term counselling offers a more reflective space, somewhere to think about how what’s happening may be affecting how you’re feeling about an event, and about your life leading to this point. The point of this approach is to give you some support during a difficult time, allow you to catch your breath and to discern truly sustainable ways forward, including addressing decision making processes: why did you chose this way? Why not that way? And so on. Some counselling agencies and some EAP’s offer 6, 12, sometimes up to 20 sessions, the NHS offers various tiers of more or fewer sessions. The constraint around limited sessions is, simply, money. EAP’s are a kind of employer insurance for which the employer pays. The NHS and counselling agencies are endlessly financially constrained. I’ve yet to hear a counsellor say “I love seeing clients for 6 weeks, solving their problems and sending them out into the world full of vim and vigour.” We are trained to work for the long term because that’s what is effective. There are very few problems that are genuinely solvable within 6 weeks, the 6, 12 or 18 session model is not based on how well problems are solved but on a cost/benefit analysis: is the client more or less likely to be able to function more efficiently in employment for a certain financial investment? You can appreciate that rationale from an employers point of view, and it’s been unspoken in healthcare for decades coming out into the open around 2015 when ‘Employment is a health outcome’ became US and UK government policy. Look at the state of mental ill health in the UK: if we could ‘mend’ people in 6, 12 or 20 sessions, either all NHS, EAP, agency and private therapists are dreadful or there’s something else going on. So why would anyone spend years in counselling? Are they indulgent? Self-absorbed? Weak? Broken? In my experience and in the experience of my peers and my profession the overwhelming majority of people who come to long term therapy are fully functional. They have families, can maintain healthy enough relationships, have at least a reasonable standard of living, the huge majority are employed - it’s one of the reasons they can afford counselling in the first place. My experience is that they’ve put aside the desperate search for relief and are engaged with the process of carefully changing the direction of their lives. It's taken decades before you get to therapy so it’s reasonable to assume it’s going to take more than 5 or 10 hours to address issues in a manner that will lead to long term change. First you’ve got to catch your breath. Then you’ve got to see if you like the counsellor. Then you need to discern if you can trust them. That’s 5 weeks or so. Then you’ll want to know the boundaries of that trust. If and when there’s a rupture in the therapeutic relationship you both have to work harder to understand what’s happening and work through it. (Why? Because although you’re paying for this work you’re so much more than just a customer, and because genuinely repaired ruptures can be some of the most enlightening parts of the therapeutic relationship.) That’s before you start talking about your real and realistic hopes for your future, or how the lives your parents didn’t live might be manifesting through you, or any of the myriad possibilities for human experience. Somewhere along the line you’ll experience a plateau where nothing much seems to be happening, then you discover you were preparing to explore something particularly illuminating. It takes time to trust that your therapist isn’t making you dependent on them, something every client will wonder about from time to time and which should be spoken about with absolute transparency, by both of you, every time it passes though your mind. It takes time to know how you got to where you are. It can take a lot more time to allow knowledge to move to understanding, then to really getting it. It takes time for the conditions to be in place for you to offer yourself sufficient compassion so that the parts of you that you didn’t know were running your life can stand down, take their proper, quieter position and let you move forwards. Because that’s what therapy is for: genuine, sustainable, lifetime change. 28/2/2022 Living In Interesting Times
Years ago, in the middle of nowhere, I got up very early and turned on the radio. There was nothing on it other than the death of Princess Diana and I was rapt, listening to the same story over and over again. My friends came down an hour later, listened while we had breakfast and then, to my amazement, turned the radio off. I stood there gaping like a grounded fish but this was their home and so I just got on with having a very good weekend. Coming back into London at the end of it I had no clue why the stations were so full, why the streets were heaving: having missed the media frenzy I was an observer rather than a participant and never really got into the swing of the outpouring of feeling that brought people to camp in Hyde Park. Like everyone else, I’ve been worried about how things are developing in Ukraine and I’ve found myself reading up on the history of the Cossaks and Tartars, of Sufis in Chechnya, North Sea oil reserves, the inventor of the AK-47, the most vulnerable points on a tank, and very nearly missed yesterday's warmth and brightness. Only when I forced myself to get out into the park did I realise what a spectacular day it actually was here, now. People in their 50’s are having fairly intense memories of life with nuclear war on the horizon on top of profound economic and social turmoil, our parents remember the Cuban Missile Crisis just 17 years after WW2. This latest cycle of international madness involves social media, a new factor that brings siege, desperation, shock, (the latest) refugee crisis, high drama and death right into our heads, in glorious technicolour, as it happens, repetitively and constantly. Whatever our age, it's worth reminding ourselves that we are living through huge weirdness. MP’s have been murdered in the street. 72 British people died in London, live on TV, and no one has been held to account. Confidence in the police has seldom been lower. 2 full years of pandemic compounds havoc in a collapsed NHS, employment turmoil, relationship breakdown, childcare mayhem, disability, bereavement. Brexit divided our country overnight, kicking off polarisation over, of all things, whether or not to wear a mask! Culture war is viscerally real. Ordinary men and women wearing nice clothes, with mortgages and respectable jobs and 2.5 children have invaded hospitals and attacked vaccination centres. The religious fervour on every subject in the US is very visible but it’s here too. Interestingly, people who experience this kind of zeal seldom come to therapy, their beliefs and communities sustain and contain them. For the rest of us, the uncertainty and strain is cumulative. What can we do about it? Be disciplined about social media use. You need to know what’s going on in the world but don’t need to be immersed in it. Can you limit it to 2 half hours a day? What’s it like to imagine that? Conflict is exciting, little jolts of adrenaline and dopamine can feel pretty rousing, but living in that arousal takes a toll. Understand that rolling news requires drama and has a great deal in common with soap opera. We are surrounded by instant experts . . . . . . in guerilla warfare, international banking systems and war room diplomacy. Avoid. No one really knows what the future holds. No one. Becoming an instant expert grants a fiction of control. Distract yourself. I am no fan of Keep Calm and Carry On, it’s a trite platitude that diverts attention from reality. But. Unless you’re going to move to somewhere out of range of an intercontinental ballistic missile (nowhere) this week, life goes on. Ordinary day to day activity is good - as is thinking about how much this day to day activity actually nurtures you. Think about strength and weakness and power, how it functions in your relationships and world view: “Real strength is getting up at two in the morning when you’re exhausted to feed the baby and let your partner get some sleep. Real strength is listening to a friend’s grief and holding them close, going to work every day when you’d rather stay in bed in order to feed your children, saying ‘no’ to a toddler and withstanding the ensuing temper tantrum, speaking an unpopular truth, listening to someone you disagree with and striving to understand their point of view, losing with grace, admitting when you’re wrong. "Real strength is a thousand ordinary acts of responsibility and caring done by ordinary people of every gender every day to keep the world running, and it requires empathy - that ability to understand that the world is full of other people who have feelings and needs and rights, just as you do, and to care about them. "Let us not confuse strength with power. A strong person may or may not have the power to get something done or stop something from happening. Real strength may mean recognizing the limitations of your power, and using the power you do have judiciously and wisely.” Miriam Simos Relationships may have to end but it’s by no means inevitable that they end with drama which simply serves to keep that relationship thrillingly alive and increasingly toxic. While some relationships must end some relationships can be improved. The focus on ending relationships can have a flavour of being a dissatisfied customer; in this model, partners are manufacturers and may need to negotiate changes to produce a better product. You may be stuck in your job and you’re doing what you can for yourself and your family. You may be stuck in your job but there are still ways to change it, to gently and reasonably change yourself within it, or to find structured, safe ways out. Any therapist who says they know how to deal with what’s happening here is kidding you and themselves. None of us have lived through a pandemic. A minute number have lived through warfare. But we do have principles that we believe to be useful: boundaries, acceptance and care for clients, empathy, the primacy of the therapeutic relationship. These principles take years to begin to embody and are as old as time, cross cultural, a bedrock of civilisation that anyone, everyone, can attempt, moment to moment, here, now. All I have is a voice To undo the folded lie, The romantic lie in the brain Of the sensual man-in-the-street And the lie of Authority Whose buildings grope the sky: There is no such thing as the State And no one exists alone; Hunger allows no choice To the citizen or the police; We must love one another or die. WH Auden 24/2/2022 February 24th, 2022 ITAR-TASS NEWS AGENCY / ALAMY LIVE NEWS /HTTPS://WWW.ALAMY.COM I grew up in very rural England during the late 70’s, hitching around the countryside at all hours, enjoying dawns, dusks and days surrounded by wide fields, big skies and very low crime. In many ways it was idyllic.
It stood in sharp contrast to the news which was filled with misery. It was very clear even in my early teens, that the country was convulsing. Every Friday night the ITV news would discuss how many more jobs had been lost. The never ending violence between police and strikers, the nihilism of punk, the crushing drudgery of poverty that was suddenly visiting people who’d expected the employment that had been guaranteed to previous generations, and the crassness of the newly rich became part of an amusing start to the weekend as my generation was introduced to satire via Saturday Night Live, The Young Ones and Blackadder. Most of us were insulated from the realities of this period, we had no strikes, poverty and prosperity remained pretty stable in the times before second and third homes, and the nearest thing we had to punk were girls putting bin bags over their party frocks. But what we did share with the rest of the country was Protect and Survive, a pamphlet and public information film telling us what to do if a nuclear bomb fell in Britain. As teenagers we knew that a mattress propped up against the stairs would not be protection from anything and we couldn’t understand why the adults around us were taking it seriously. I asked my mother about it and she said this: “Look at the quality of the film. They know that it’s pointless.” I found her acceptance of the futility of all of it strangely comforting, there was a weird kind of peace in her acknowledgment of mutually assured destruction. In fact, many people were very much more than aware but CND was considered dangerously radical in North Shropshire. My RAF armourer father told me that nuclear weapons put food in my mouth. A couple of years later there was Threads. After watching it I went to bed in no little fear that I tried to sooth with planning. Where could I keep a secret stash of supplies? What supplies would I need? Where could I get a gun and ammunition? Before I finally fell asleep I knew it was useless and my mothers existential despair descended on me: in many senses that despair allowed me to move on. I left home, moved to London where surviving day to day distracted me from war even though the issue was very live and I went on marches and a Die In at Parliament. I watched When The Wind Blows and, rather than having any compassion or sympathy for Jim and Hilda, felt disgust for their bovine trust. And here we are again. Russia bombed Kiev this morning. A huge number of American politicians and voters are expressing sympathy for Russia: if you’re under 35 you might not appreciate how surreal that is. Today's Daily Mail’s front page criticises our Intelligence Services for being ‘Woke’; the Markets are volatile, this is a moment for really quick profits if you’re savvy and lucky; the media is having a field day, it’s all very exciting. Like everyone else, I’m preparing for another working day, not cancelling any social appointments, not marching on parliament, not writing to my MP. The world seems seldom to be out of crisis, very many ordinary people live the entirety of their existence in quiet desperation with genuinely no hope of respite, whether that’s through poverty, illness, a sense of duty or a lack of imagination. Perfectly lovely people, people you’d happily have over for dinner and be pleased to have as neighbours, create the conditions for despair to thrive. What can we do about it? Are the Hard Working Tax Paying Jim and Hildas better or worse off trusting their betters than despairing protesters who know what war actually means? Are the bloviating Я Boyz gang happier than people hand wringing over how isolated the UK is? You won’t be surprised to hear that despair is pretty standard fare in therapy but over the last few years despair about the state of the world rather than the state of an individual life has become a thread that runs through increasing numbers of narratives. Brilliantly functional people whose lives look pretty perfect (from in and outside) are also consumed by unshakable anxiety, a sense of dread and the overwhelming but secret fear of being found out. The intersection between personal and political is becoming harder to discern as one leaks into the other. Isolation is a structural part of this dynamic: a society that lauds success must despise failure, and so pretence seems vital, becomes habitual, increases the despair because you can only dance prettily for daddy for a limited amount of time before exhaustion kicks in - yet still you must dance. In an ideal world, we’d stop dancing when we realised that the music was discordant but the rewards for throwing ridiculous shapes can overwhelm reality. It’s why so many MPs take vast amounts of money and other benefits from private individuals and businesses : many are genuinely nihilistic, believing that there's no such thing as society and consequently that all that matters is making their life as comfortable as possible at any cost, because if they don't others will. In an ideal world, we’d be able to talk with our peers, listen and be heard, and have some power to alter the conditions that make life difficult, but that’s never been part of our culture (something that many other developed societies find bewildering.) So what can be done when despair takes hold? Understand that despair can sometimes be the cost of years of denial. It can manifest as anxiety, panic attacks, intrusive thoughts, compulsive behaviours, burnout, depression, deep sorrow, agitation, and even a feeling of restless excitement. Somewhere in there, there may very well be shame. Guilt is a reflection of what you’ve done, and you can make amends, put things right. Shame is a reflection of who you are - and how do you make that better? Despair occurs when you become aware of your essential powerlessness - you’ve done all the right things and life is still not good. It’s not unusual for people to metaphorically throw their hands up in the air, understand that they’ve been wasting their time trying to be decent, and begin investing in armaments, polluting industries and other high yield stocks, buy the second home and the performance car, the cans and the drugs, throw their spouse away, because life is short and nothing matters. So start where you are, you are not going to change the world but you may be able to improve your relationships. Try new conversations with your children, partner, parents, friends and don’t expect instant results, life is not a Pot Noodle. Think about the boundaries you’d like to set with the friend who sucks up your time but doesn’t reciprocate, the manager who abuses your good will, the child whose behaviour has become tedious or too compliant, the partner who seems more like an annoying flatmate or a comfortable stranger. In the last 70 years we’ve lost all sense of meaning and purpose beyond having stuff, not even money - household debt has never been higher - but the trappings that signify success. Religion and charity are almost entirely reduced to an uncomfortable charade; retired businessmen used to go into politics as a way of giving back to society and while it’s never been clean, it’s seldom been more polluted. That doesn’t mean that you’re obliged to ignore the traditional sources of meaning and purpose. If the idea of working at a food bank is too much then hand over some money. It’s a fact that poorer people give more to charity than rich people, so knowing that put 10% of your weekly supermarket spend aside for the foodbank box by the tills, just to see what spending 10% on someone you’ll never meet feels like. Next time transfer the money anonymously. See what that feels like. Life is short and then you die, but rather than acting out (performing what you can’t find words for) find the words. This is what therapy is for. God knows, if Mr Putin and Mr Johnson and the rest of these apparently very successful people had spent some time trying to find some words to describe how they felt they might have been less inclined to physically compete against children, support terrorist organisations, sow chaos, cause terrible hardship and become paranoid, small and pathetic. You may not enter the history books, but you can do better than most of the people who do. 24/1/2022 Getting A Grip On The Zeitgeist No one alive has experienced what we’re going through right now. The 1918 flu pandemic which killed more people than WW1 is our nearest analogy, spread by soldiers returning from the first mechanised Total War. The chaos of the early 20th Century may seem to outweigh what we’re going through today but as any therapist will tell you, comparisons are seldom useful. Whatever side you take on Brexit, masks, vaccinations, covid restrictions, the Prime Minister or any other national issue, they’ve all uncovered attitudes within our neighbourhoods, sometimes within our own families, that can be shocking. The slow dawning that friends, colleagues, parents hold views that are the polar opposite of what you believe to be obvious can be deeply destabilising to relationships and therefore to trust and to the concept of who you actually are. We’re entering the third year of covid restrictions which, despite what the media may say, have been a balm for a great many people, not least disabled people, many of whom have had to live this way for much of their lives and who have for years been telling employers that working from home is entirely possible. Now, that security and belonging is being threatened. For others, not being able to be physically near other people throughout the day has been overwhelming. For all of us, the uncertainty that surrounds restrictions is upsetting: some of us watch the numbers of deaths and cannot believe that masks are no longer allowed to be used in schools. Some of us cannot believe that this virus has caused such an assault on personal liberties. Covid has illuminated the managerial paranoia of people who believe that everyone who isn’t them is a slacker. As a result, a great many people perform work rather than do much actual work: a really dismal state of affairs for everyone but especially for the majority who have seldom worked harder or longer. Growing numbers of people are realising that it’s not just a mythical other who is having to use food banks; they too are beginning to think about how they’re going to pay utilities bills. The post is taking longer to be delivered. Queues for everything are that bit longer. The NHS stopped coping over a year ago. The streets are a little more littered. There are more empty shops and emptier shelves. The news reports on Adele for 3 days and ignores month-long 17 mile Dover tailbacks. The build up of hostilities at the Ukraine boarder is at last being brought into public awareness and it’s terrifying. We haven’t begun thinking about that refugee crisis. We’ve become used to the idea that ecological collapse is unavoidable and we haven’t begun thinking about that refugee crisis, either. But there’s no shortage of opinions about refugees. And the weather. Don’t underestimate the impact of two months of almost total cloud cover at the coldest, darkest time of year. ‘Self care’ is being able to take a proper holiday, not having a bubble bath. It’s not just a lack of disposable income that prevents people from having a genuine break, but the knowledge that they will come back to hundreds of emails - at the same time as seeing that nothing much has actually changed. That can lead to the chilling fear that despite all the URGENT emails they may well be disposable. The Great Resignation is largely driven by the despair of healthcare and tech workers who experienced extreme increases in demand due to the pandemic, rather than by newly liberated souls becoming digital nomads. If you’re a lorry driver, wages have increased but conditions remain crude: for most people, whether they’re in golden handcuffs or struggling to pay the rent, anxiety is an everyday reality. If any therapist tells you they know what to do about this accumulation of unprecedented pressure, let me reassure you that we do not. We’re feeling it too. Donning the mantle of expert can be very comforting, and lucrative, when things become uncertain but it’s seldom honest. So why come to a therapist at all? To take a non-judgemental deep dive into your life and see what can be adjusted and what must be accepted. To reassess what is meaningful for you - without which life becomes a little bit hellish. To be in a place where you don’t have to perform at all but can take the time to make sense of how you are, how your relationships are, how you feel about it all. To take a clear look at how much pressure you’re under, how the pressure your family, friends and other people are under may be impacting you, without the demand to ignore it and carry on. To reset some boundaries. To have reflective time, to remember who you genuinely are, to reignite a little creativity and then, rather than it being a cunningly planned strategy, to naturally evolve into a future that fits you better than the present. Whether you come to therapy or not, cover the basics: drink water, eat decent food, get quality sleep. Give your close relationships some positive attention. Stretch a bit, get outdoors once a day. Yes, the numbers of people suffering terrible poverty is shocking right now, but that doesn’t mean that your troubles are unworthy. Don’t add to the miserable zeitgeist: think about addressing it. 12/11/2021 You've Burned Out. Now What?https://www.hse.gov.uk/statistics/causdis/stress.pdf In a healthy alternative universe your workplace protects against burnout by putting policies in place that people are expected to adhere to, things like not sending emails before 9 or after 6 and taking annual leave. It’s a measure of how unbalanced employment has become that the thought of limiting work to one time zone is considered unrealistic.
“Mental health” and “wellbeing” have become fashionable in many workplaces and more often than not serve solely to act as paper-based proof that an organisation is addressing the mental health of their staff. Making attendance of a mental health event compulsory is a huge red flag that your workplace is not interested in anyone's mental health, prioritising PR ahead of genuine attention to what harms or protects people. Careful management of workplace culture, building beyond blunt legal minimums, supporting meaningful activity, observing actual rather than performative productivity, keeping a benevolent rather than a suspicious eye on how many hours people are working is much harder than buying in an ‘expert’ for a few hours and ticking a box. The number of people experiencing burn out is increasing and paradoxically knowing this you can take heart: it’s not you. It’s the zeitgeist. It’s the culture of work. It’s the culture of your workplace. We so often say “So and so’s burned out,” when it’s almost always more accurate to say “Their workplace burned them out.” So here you are with a note from your GP and a couple of weeks off. Now what? Understand that burnout is the equivalent of an RTA. Your organs, including your brain, have been harmed. Your immune system is compromised. You’re very likely to be both anxious and depressed. You’re very likely to experience physical problems - headache, stomach ache, muscle pains, blurred vision, palpitations, high blood pressure. You’re very likely to be exhausted - not tired, exhausted - irritable, jumpy, fearful, tearful, angry, bewildered, resentful, feel guilty and shameful. (Guilt is about what you’ve done. Shame is about who you are.) You can't make decisions, including what you want to eat or what film you want to watch. And you don’t have a bruise or a lump to show for any of it. This can be difficult for partners and friends as well as you to understand. In some senses it would be easier if you had been knocked over and had pins and plates in your leg from a severe break: people would send you grapes, not invite you out to dinner and not be surprised when you don’t return to normal after a week. Rest This is often easier said than done. Insomnia and restlessness are part of the adrenalin/cortisol response which become disordered under chronic stress and deranged in burnout. You may sleep for 16 hours or 2 and in the first few weeks even if you get enough sleep you may only be able to shower and brush your teeth before feeling exhausted. Slumping in front of the TV is ok, it’s what box sets are for. If you have children call in all the Covid-safe help you can get, don’t for one moment feel guilty about it. Talk with your GP Ask your GP for an MOT and ask how they feel about testing your thyroxine and blood sugar levels along with red and white blood cell counts - it’s only 1 needle. Low or high thyroxine levels, anaemia, incipient diabetes and underlying infections make everyone feel lousy and are easily treated. Women over the age of about 40 might want to talk about HRT - no blood test is yet sensitive enough to pick up on perimenopause but symptoms can be controlled safely. Medication I’m not a doctor, your GP is expert in the side effects and interactions of medication and how they may help or harm you as an individual. If you had diabetes or dangerously high blood pressure you wouldn’t expect to tough it out, you’d take the meds because you don’t want to go blind, get your foot amputated or have a stroke, and you’d consider what changes you could make to help your condition. So it is with stress and burnout. Physiological changes from burnout can lead to heart attacks and strokes, weight gain with all that this can lead to, and hormonal changes. This is not all in your head, burnout is also very directly in your body. Propranolol is a drug that is primarily used for heart problems but it works well for anxiety too. It’s been used by some Olympians to reduce unhelpful performance anxiety and is so effective that it’s been banned in sports. Propranolol reduces the impact of adrenaline, doesn’t make you feel strange, isn’t addictive and when you don’t need it any more there’s no withdrawal. It isn't an antidepressant. It helps stop anxiety from becoming a habit, and helps break that habit. If you’re unable to be still or get any sleep, your GP might offer a very limited number of Diazepam tablets and a sleeping tablet called Zopiclone. Diazepam can offer extraordinary relief from severe anxiety, Zopiclone can help reset short term insomnia. Both drugs will cause dependency which is why GP’s prescribe so few of them. In the right circumstances they can offer real relief. Many antidepressants also help with anxiety, some can be effective in helping you sleep. You’ll need to give them a couple of weeks to work properly and for your body to adjust: the right pill at the right dose for the right length of time can be a good support. Take a good multivitamin, plus magnesium and vitamin D, every day. Give your body the support it needs. Try to establish small routines Sleeping and waking Aim to be in bed and to get up at set times. Our bodies are very like the bodies of other animals, so just as your dog learns through repetition when it’s time to be walked, to be fed, to play, to go to sleep, so do we. A sleep routine might be: 6pm have supper (go to bed on an empty stomach) 7pm wash up, 7.30 watch a film, 9.30 read, lights out at 10. A waking routine might be: get up when your partner does, wash, get dressed, have breakfast, wave the kids off to school, clear up, rest. Food and water Aim to eat 3 nutritious meals a day - if you can afford it consider buying in meal kits where ingredients are weighed out and good quality and recipes are simple. Drink a little water every hour, drink more water than coffee or tea, and more tea than coffee - set an alarm to remind you, don’t put it off. Your brain and the rest of your body need water. Exercise Don’t worry about exercise to begin with. We’re so immersed in the idea that every waking hour must be used to improve our defective selves that the idea of not doing purposeful exercise can seem counterintuitive. But your brain and body are worn out. Just as you wouldn’t consider going for a run on a broken leg, so you are now allowed not to use every waking hour to prove how productive and driven you are. Don’t stay in bed but do learn the joy of pottering. Clean the bath. Write a letter. Put the dishes away. Polish some shoes. Do some laundry. Sit in the garden. Mend something. Play with the dog. Read the kids a story, have a conversation with them that doesn’t involve education or self improvement. Have a conversation with your partner that doesn’t involve planning for the future - plants, elephants, Bolivia, anything that’s interesting but not necessarily preparing for some kind of task. Try to get out once a day, buy a paper, sit in a cafe or post a letter, mainly to breathe deeper and get some daylight, even on a rainy, cold day. Walk the dog, take the kids to the park and keep the rest of your diary free. You’re aiming for a small sense of satisfaction at the end of the day. Give yourself time Two weeks seems like a massive indulgence but burnout can take months to recover from. GP’s know how impactful burnout is and will happily sign you off work. In my experience it’s the person who’s burned out who is anxious to prove they’re not slacking that puts pressure on themselves. HR understand the reputational damage to an organisation that burns people out which is intensified if they pressure people back to work. Expect very little from yourself but allow each day to pass knowing that you’re soothing your nervous system, resting your overstimulated brain, glands, heart and other organs, allowing them to return to normal function as they will over time. In 4 weeks you’ll see a noticeable difference which you can trust your body and mind to build on. Don’t set goals: if you fail you’ll become anxious and disappointed. Healing is not an exam-tested subject, this is an opportunity to watch your body and mind find their own way. Money If you’re employed you are legally protected from returning to work before you are well enough. This legislation exists because untold numbers of people have been severely harmed by terrible employment practices. Take the legislation seriously. In a couple of weeks talk with HR who will have all the details including how much pay you are entitled to while ill. HR exists to protect the employer from legal liabilities - they will not want to be taken to court - and they will be clear on next steps. Many organisations also have occupational health staff who can help an employer understand what individual people need, and if your organisation has one, use them. If you are self-employed you are still entitled to financial support, and don’t hesitate to claim it. A benefits system is a measure of a civilised society. The forms are notorious, you're not stupid if you can't fill them in, they're designed to prevent people from claiming, so ask for help from one of a number of agencies. Therapy In therapy, which people often come to in the first weeks of burnout, we talk about how they’re feeling, keep an eye on things like sleep and how relationships with partners and children might be, see how things are ticking over. Over time we begin to look at where their concepts of work, worth, status, identity might have been built, where they absorbed ideas and ideals from, how they came to understand different things to be more or less important. In time we take a long overview of how parts of the past may have led to this place, what may need to be tweaked to make the future more balanced, and begin to experiment with how it is to start doing that. It can feel like a conversation, it’s absolutely not any kind of test or education, and people consistently find that they know what they want and need from their future, rediscovering innate skills to slightly alter how they approach parts of their life. A one degree change in trajectory results in a very different direction. Rest. Let things evolve. Take help where it’s available. You’ll get through this.  A great deal of the literature on burnout is written about white, middle class men. The explosive anger, irritability, cynicism, becoming distant with partners, friends and children that the literature describes are all real and all much more likely to manifest in people where these behaviours are accepted. Imagine a woman, whether in the boardroom or anywhere else, standing up so quickly she pushes the chair over and storming out of a meeting. Becoming explosively furious about little things. Shouting at people who work with her. Bingeing on alcohol or drugs. Spending all night on a video game. Punching a hole in her office wall. Imagine a person of colour doing that. Imagine what would be said about that woman, especially a black woman. Compare it with what is said when white men do exactly these things. Burnout is brutal whomever it happens to and it manifests and is treated differently depending on who expresses the accumulated angst of a particular workplace. A number of studies suggest that burnout impacts more women than men and that the pressure on black women means that they are "paid less and have to work twice as hard to be noticed or gain the same opportunities as peers." Covid definitely has had a different impact on women than on men. It’s quite straightforward that on average mothers do more housework, childcare and caretaking in general than fathers, and covid added full time teaching to the mix. Women are more likely to feel frustrated at work because on average we’re more likely to be in positions with less authority, earn less than the equivalent man and therefore have less power to create changes to faulty processes. Our ideas are less likely to even be heard, let alone acted on. This is compounded for black women where “higher effort/reward imbalance, greater job demand, and lower control over work were all associated with work stress.” It’s quite clear that sex, ethnicity and income have definite impacts on wellbeing in any context, but how might it manifest in people who are not well paid white men? I’d propose that the main difference is that anger is stifled. People who are used to having to shut their mouths to avoid punishment learn to swallow their anger and are much more likely to turn that exasperation, overwhelm, shock, awareness of inequity, impatience, and discomfort on themselves than people who are used to being listened to and taken seriously. In general, women have learned to ‘tend and befriend’ in stressful situations while men are more likely to respond with ‘fight or flight’. It takes a lot longer and a lot more energy to build and cultivate relationships than it does to blow them off. A vital difference is the exhaustion that different groups can bear: women expect to do most of the thinking and planning as well as most of the work around relationship building, housework and childcare while being employed. The energy it takes to simply not be a well-off white man - absorbing everyday insults, both unconscious and conscious, and the monstrous impact of knowing that if you're murdered it's no big deal, or that you can be more qualified than your boss and still not be taken seriously, of not having the financial ballast to take a taxi rather than the bus at the end of a crazy day, to have breaks or treats or to eat well, to not have food just appear - can’t be overstated. Endurance becomes a muscle that is necessary to over-develop so please lets never speak of 'resilience' ever again. McKinsey addresses this head on, it’s easier for many people to look at these issues as a matter of productivity and reduced liability than of simple, appalling facts. So while white, well-off men will also work harder in an attempt to do better, people who are not them are working very hard as a baseline. While the pain and frustration of a job that has lost meaning is awful for anyone who experiences it, people with less power have less opportunity to do anything about it and are often much less tolerated if they express that pain. While the environment around white, well-off men bolster them against the problems of a workplace and of the world in general, the environments around people who are not white, well-off men compound those peoples problems. It’s a cliché that in similar situations men get angry and women cry - god help the man who cries or the woman who gets angry - but when women and people of colour internalise all this it can manifest as depression, anxiety, brain fog, headaches, muscle pain, coughs and colds, binge eating or reduced appetite, digestive problems, things that take them to their GP who will give them meds to deal with symptoms. Whereas when white, well-off men burn out they are much more likely to quite rightly take time off work to recover. No matter who experiences it, burnout is not weakness, it’s a symptom of inefficiencies that disproportionately impact engaged, intelligent people who do more than just follow orders. When it manifests dramatically in people who are allowed to be dramatic it's taken seriously: it’s so much easier to ignore its clear manifestation in people who have been taught to keep their heads down. There are still a great many organisations where open sexism and racism are everyday realities, where people in power push the boundaries of illegal behaviours because they know no one will stop them. If this is your workplace, get out. Respectfully acknowledge the internalised voices of friends and family who told you to grit your teeth and take it, and then put them to one side: all you need to take is your self-respect, your entitlement to sick leave and the time to apply for new jobs in a market that has suddenly opened right up. You absolutely do not have to fight this fight for anyone else. Why would you turn to face an enemy when you have so few resources? Recover first. Rediscover the strengths of community, mutual support, right relationships, being able to ask for and accept genuine support and re-member who you are. Therapy can be a useful adjunct to this process, many workplaces offer it as a benefit. Black and Brown clients who may not resonate with any therapist offered by an EAP might also want to take a look at Black, African and Asian Therapy Network, Aashna Counselling and Psychotherapy, Nafsiyat, or the Muslim Counselling and Psychotherapy Network. 4/11/2021 Burnout
“Burnout” has become a bit of a buzzword, being used to describe feeling exhausted and stressed. Exhaustion and stress are real, but burnout is another level of collapse. I’ve seen more cases of impending or actual burnout in the last 6 months than I have in 17 years. Covid has meant that workplaces and people have had to turn on a sixpence but this doesn’t seem to be a foundational problem for people experiencing burnout. If there’s one defining issue, it’s loss of meaning. There will be a number of reasons for this, but since I have no control over how businesses operate it's probably not useful to go into them here. People can work extraordinarily long hours and not burn out because they’re gaining some reward. Money helps but this is seldom the problem. When you can see no end to pointless or even counterproductive activity it’s utterly demoralising. Your team's goals are X, you have particular skills and experience in X and your organisation is doing Y even while it’s saying it’s committed to X. You’ve spoken with whomever you need to, used all your interpersonal and managerial skills, and you become aware that nothing is going to change. But you can’t quite believe that superbly qualified people in a high status organisation are going down this route, you just haven’t communicated with them properly, so you work harder, learn more and chillingly, come to the same conclusion. One of the signs of burnout is the belief that if you just work harder things will improve. From the hamster turning the wheel the wheel begins to turn the hamster. Sometimes this results in the hamster being thrown from the wheel - people having accidents that force them to take time off work - the midwife who falls and breaks both wrists, the producer who takes their first break in months who breaks a leg while skiing - fateful escapes that force them to realise that the world did not come to an end when they did not go in to work. People who aren’t thrown off the wheel can work harder and start achieving less, adding to their confusion and misery. It’s worth looking at these two pages that describe burnout, one from the NHS, one a classic 1996 Harvard Review of Books essay. The NHS page talks about “Individuals who are not emotionally self-sufficient” who “engage in avoidance coping strategies such as denial, disengagement, or substance misuse” or who “react negatively to situations not meeting their high standards” who don’t have “the ability to reinterpret or reframe a challenging situation optimistically.” The NHS, while superb at diagnoses, has ancient history of blaming people for their own suffering, something that many workplaces replicate. The HRB is much more nuanced while being just as straightforward about “ (1) chronic fatigue; (2) anger at those making demands; (3) self-criticism for putting up with the demands; (4) cynicism, negativity, and irritability; (5) a sense of being besieged; and (6) hair-trigger display of emotions.” as well as being “indifferent to friendships and often hostile. They had become rigid, had short fuses, and were distant from their children.” but adds: “Understandably, managers tend to rely on their best people; but the best people are more vulnerable to becoming burned-out people. The overconscientious, in particular, need to take time off from the demands of their role and to spend that time in refreshing recreation. The military has learned this lesson, but management has not.” Britain is well know for our lousy management skills and I don’t want to get into why that may be here. But creating scapegoats is a tried and tested way of turning the truth-teller into a sacrifice that makes everyone else feel temporarily good about themselves. Get rid of the troublemaker and the office can get back to normal. But now there is no truth-teller and so truths begin to be felt by everyone once more and the cycle continues. If you’re seeing signs of burnout in yourself, think very hard about what you’re doing. Know that it can take many months, sometimes years, to recover and not infrequently that means not being able to physically do anything other than sleep and watch TV for weeks. If you suspect you may be beginning to burn out and are in a role with decent sick leave and pay - most managerial and all executive roles do - take it now. If you’re stuck with statutory sick pay, don’t bother putting the extra hours in: do your job, go home at the end of your hours, look for ways to get a job where you’re treated with a little respect or at least earn enough to create savings to see you through a decent break. If you’re not yet at that point, how would it be to tell your manager that you won’t be looking at emails before and after set times? If you’re afraid of doing this, this is information: why would an adult be fearful of putting entirely reasonable limits around their workload? Globalisation is real and so is the need for R&R. UK productivity compares poorly with France who instituted the right to disconnect in 2016. Bullying is everywhere, especially in those professions that are linked with caring. Corporate and commercial organisations have learned that a culture of genuinely addressing abuses of power is linked to greater productivity and a better reputation. Even so, standing up to bullying often takes more energy than it’s worth. Consider if discretion might be the better part of valour: seeking a new role before your confidence is eroded may be the best choice. If you find yourself asking why you’re trying to save an organisation that seems intent on wasting time, money and resources TAKE NOTE. Test the waters, ask for guidance and clarity and if, having received it, you still believe your employer or department is actually working against itself, think very hard about getting out. It doesn’t matter if you’re right or wrong, if you simply do not believe in what you’re doing but remain, you are very likely to burn out. Don’t wait until you hate your manager and divide your colleagues into enemies and allies, don’t wait until your manager asks to have an informal word with you about your attitude or productivity, don’t wait until your partner, children and friends get tired of your inability to be with them or of your irritability and ranting when you are. Therapy can help you stand back, take stock, strategise on how to improve your life and gain some understanding of how you got here. Burnout can be devastating. Don’t wait for it to savage you before you acknowledge it. 3/8/2021 Go Back To Get On?
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CategoriesAll Abandonment Abuse Ancestors Anger Anxiety Ash Wednesday Attitude Banking Bereavement Birthday Bravery Breivik Bystander Effect Camila Batmanghelidjh Carnival Cbt Challenger Charlotte Bevan Childbirth Childhood Children Christmas Coaching Compassion Contemplation Control Counselling COVID 19 Culture Dalai Lama Death Death Cafe Democracy Denial Depression Domestic Violence Dying Eap Earth Day Empathy Employment Eric Klinenberg Ethics Exams Existential Failure Family Annihilation Fear Founders Syndrome Francis Report Gay Cure Genocide George Lyward Goldman Sachs Good Death Greg Smith Grief Grieving Grooming Groupthink Happiness Hate Hungary Illness Interconnectedness Jason Mihalko Jubilee Kids Company Kitty Genovese Life Light Living Loneliness Love Mandatory Reporting Meaning Men Mental Health Mid Staffs Mindfulness Money Mothers New Year Nigella Lawson Optimism Organisational Collapse Oxford Abuse Panama Papers Panic Panic Attacks Parenthood Petruska Clarkson Pleasure Politics Positivity Post Natal Depression Power Priorities Priority Productivity Psychotherapy Ptsd Red Tent Reflection Rena Resilience Riots Rites Of Passage Ritual Robin Williams Sad Sales Savile Scared Seasonal Affective Disorder Self Care Self Preservation Self-preservation Shock Sin Singletons Sport Spring Status St David St Georges Day Stress Suarez Suicide Support Talking Terry Pratchett Time Transition Trauma True Self Truth Understanding Unemployment Valentines Day Viktor Frankl Violence Whistleblowing Who Am I Winter Blues Women Work Archives
May 2022
CategoriesAll Abandonment Abuse Ancestors Anger Anxiety Ash Wednesday Attitude Banking Bereavement Birthday Bravery Breivik Bystander Effect Camila Batmanghelidjh Carnival Cbt Challenger Charlotte Bevan Childbirth Childhood Children Christmas Coaching Compassion Contemplation Control Counselling COVID 19 Culture Dalai Lama Death Death Cafe Democracy Denial Depression Domestic Violence Dying Eap Earth Day Empathy Employment Eric Klinenberg Ethics Exams Existential Failure Family Annihilation Fear Founders Syndrome Francis Report Gay Cure Genocide George Lyward Goldman Sachs Good Death Greg Smith Grief Grieving Grooming Groupthink Happiness Hate Hungary Illness Interconnectedness Jason Mihalko Jubilee Kids Company Kitty Genovese Life Light Living Loneliness Love Mandatory Reporting Meaning Men Mental Health Mid Staffs Mindfulness Money Mothers New Year Nigella Lawson Optimism Organisational Collapse Oxford Abuse Panama Papers Panic Panic Attacks Parenthood Petruska Clarkson Pleasure Politics Positivity Post Natal Depression Power Priorities Priority Productivity Psychotherapy Ptsd Red Tent Reflection Rena Resilience Riots Rites Of Passage Ritual Robin Williams Sad Sales Savile Scared Seasonal Affective Disorder Self Care Self Preservation Self-preservation Shock Sin Singletons Sport Spring Status St David St Georges Day Stress Suarez Suicide Support Talking Terry Pratchett Time Transition Trauma True Self Truth Understanding Unemployment Valentines Day Viktor Frankl Violence Whistleblowing Who Am I Winter Blues Women Work |
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