Transcript for Episode 68: Battling Burnout

NASW Social Work Talks Podcast

Cat McDonald:
Welcome to Social Work Talks, I'm Cat McDonald. The magnitude of the stress that humans are under right now is beyond measure. 2020 brought with it a pandemic, highly publicized murders of black people by the police and subsequent outrage in the streets. In the United States alone hundreds of thousands of people have died from COVID, hundreds of thousands have lost their jobs, many are working or schooling from home, many are experiencing high levels of anxiety, grief and social isolation. Social workers are helping people navigate these times. At the same time, social workers are of course human beings in this environment, dealing with challenges of their own.

Today, our guest is Kelley Bonner, a social worker who specializes in compassion fatigue and burnout. She helps people stay passionate about the work of taking care of others.

Welcome to Social Work Talks, Kelley.

Kelley Bonner:
Thanks for having me, I'm excited to be here.

Cat McDonald:
Tell us about your social work practice and your own experience with burnout.

Kelley Bonner:
Yeah, so I have been in the field for about 15 years, I'm a licensed clinical social worker. I currently do more psychosocial education around burnout, but my background is actually in forensic social work. So I started my career in prison systems, which is where it led to burnout pretty quickly. I've worked with veterans, I've worked with active duty, I've worked a lot with people with sexual trauma and trauma was my main focus and my main interest, both inter generationally and also just working with women who are victims of sexual abuse.

That's kind of my background and right now I work with corporations, individuals and groups about how to kind of prevent and heal from burnout. And that comes from, as you asked, my own personal experience where I spectacularly, as I say burned out, of a job when I was working in a prison system, that was my first job. In my early twenties I started working in prison systems and doing behavior modification programs with inmates were the worst behaved in the state at that time, and I didn't have the tools and I didn't have the language, which is something I'm really passionate about that most people feel burnout, but don't know what it is and don't know the word and how to use it properly and certainly aren't taught on how to do this in this field.

And so I took on a lot of things I shouldn't have taken on. I put the world on my shoulders. I was working in a very resource depleted environment and three years into that job was in a puddle on the floor, as I say, sobbing, quitting, no job following up, just couldn't do the work anymore. And it wasn't until many years later when I was looking at offshoots of trauma and traumatic stress and secondary traumatic stress and how that impacts clinicians, that I realized this word called burnout, I said, "Oh, that's what that was that many years ago." And I hadn't treated it and I still had like remnants of it because a lot of it was mindset things, mindset shifts I need to do to prevent it in the future. And so I carried around with me this kind of weight that was burnout.

Cat McDonald:
Wow. Actually you have a podcast yourself and you have an episode on vicarious trauma. I'm going to link to that in the show notes, but since you mentioned trauma work, can you talk about what you learned about vicarious trauma and how it affects social workers. First, what is it and then how it affects social workers.

Kelley Bonner:
I say very simply vicarious traumatization which results in secondary traumatic stress is just the result of practicing and the presence of pain that oftentimes when we enter our work, we don't meet people who are well or where they need to be or in perfect health. We meet people with some kind of struggle, and so as they talk about their pain, witnessing it, internalizing it, leads to being traumatized. And it is separate from PTSD, people can experience that, but vicarious traumatization is when you are hearing someone else's pain and you are practicing in that presence and it absorbs into yourself. So you end up carrying it, you carry some of their trauma. And that happens very often in our field, of course, because most of us, like I said in the outset, are working with people who are in pain of some sort.

And so we sit with them, we try to help them navigate it, we try to provide tools and different things, but that pain ends up being transferred into us. And it shows up in a host of ways, but can even include having decreased immune system functioning. So people get sick a lot when they're stressed, right? Weight gain, fear and anxiety, rumination, we're just stuck on a thought over and over again, isolating ourselves because people don't understand necessarily what we're going through in our day-to-day lives, our partners, or our family members. That leads to relational problems with those people in our circle outside of work. Hopelessness, and then the other side of the coin is it increases impulsivity, whether it's to eat more, drink more, engage in unhealthy sexual practices, those all can be the result of a traumatic stress response and secondary traumatic stress particularly a vicarious traumatization.

Cat McDonald:
And how does that affect social workers on sort of on a day-to- day basis?

Kelley Bonner:
It's very evident to me, I think about my own experiences and I think about it just in general, in the field, how it affects social workers. It really started for me as the way I simply say it, as I started having reduced joy, right. That was like the simplest symptom looking back as to how that showed up. I was unable to enjoy the work I did. I'm a pretty bubbly person by nature and that was gone. The shine completely wore off really quickly, so that was the first thing that went. When I saw that people were excited, I was like, "Why are they so happy? Life isn't that great."

The other way it manifested in social work in general in my practice is I was having difficulty connecting as much. I would find myself disassociating and not in the clinical actual traumatic stress necessarily, but numb and disconnected from my patients or clients as well, and customers. I really just felt like I couldn't any more connect with them, I felt like my cup was kind of full emotionally. And so if someone was saying something that was sad or traumatic, I was faking the reaction, I wasn't necessarily feeling it.

And I also felt isolated and overwhelmed by the amount of work. That was another thing that showed up that I was constantly overwhelmed. We talk about demands and resources with burnout, that's another component of it that will surely probably touch upon, but one of the things that first present is I always felt like I was starting every day at the bottom of Mount Everest. And I was going to have to climb it and I knew I wasn't going to make it to the top, that was just a given. And that was the way I felt daily, overwhelmed, numbed, disconnected. I felt very isolated and loss of joy.

Cat McDonald:
Yeah. So what did you do to get out of that? You quit your job, you quit the super stressful job, then how did you go from that point back to joy?

Kelley Bonner:
And I would say that sometimes you need to quit a super stressful job, that sometimes is the answer. A lot of times I realized it was just adjusting in me. And so one of the things I teach people is a lot of it is about these five kinds of resilience skills I teach people that treat burnout and treat the kind of trauma that comes from practicing in the presence of pain. And once I started practicing those things, one, I became much less likely to burn out and to be traumatized, and two, I was able to appropriately advocate for myself and know when it's like, okay, this situation has gotten so bad, this job or whatever I need to get out because it's not me, it's the job or conversely, I know when I need to step and kind of bolster those skills.

And so, one of the things that I teach people is that one of the resilience skills is getting back to intentionality and reminding myself, why do I do what I do? Because along the way, when you are stressed out and traumatized and burned out, you forget that, Oh, I actually like this job, I actually like this profession. I chose this, this is something I volunteered to do. And it's reminding yourself what that is. You know, why am I here? What are my values as a human and what I want to bring to bear when I come into this work? Why do I want to be a social worker? And what about me particularly wanting to help people? And getting really connected in that and developing, I developed a personal and professional mission, like what was my mission in life? And how did that connect to the practice of social work and the practice of working with the individuals I worked with.

And then I kind of held myself accountable to be like, what are the ways I can look up to that? That was really key for me, was developing a career kind of timeline to one, see the different jobs I had and what I loved about my job, versus what I hated, because that was clear at the end. And then also being really clear on that personal mission statement, like what is it that I want to bring to the world and to my practice? And then judging myself, my successes and my failings, of a day not on how much paperwork I accomplished, if I was able to change my clients' lives in any way or my patients' lives, but more so on did I live the values that were important to me? If I want to be compassionate, did I make space in my day to have compassion for the person sitting before me and judging that as a success. So that was one of the main things I also did.

A second thing I did was really get clear on becoming more professionally mature. And that was difficult for me because I thought I'm a great clinician. I'm really good, like I am great working with trauma, people who've been traumatized and with trauma itself or something. I was really good at it, I saw clients change and grow and others not, but I was really professionally immature, even years into practicing social work, because I was still trying to hold myself responsible for client outcomes and I was still going on the rollercoaster of two steps forward, five steps back. I was still trying to see a way that I was somehow responsible for someone's successes or setbacks.

And when I learned to let go of that, that this was only just an opportunity for me to practice the things that are important to me, not get so caught up in being, you know, super woman or super man or super person and rescuing a client, that was a huge breakthrough. And the other piece was accepting that because I'm choosing this work, because I am choosing to be here, that there is always going to be more asked of me than I could possibly give in a day, that that is the nature of the work we choose. We have chosen a field in which there will always be more wanted and asked and needed than we have the resources and an ability to provide.

And while that sounds on the face of it, to be kind of depressing and overwhelming, it actually was freeing because it made me readjust my priorities. There will always be case notes and treatment plans and paperwork that I will never ever finish, even if I had 25 hours in a day. If there is always going to be more people who need help, then I need to prioritize my own health, like how I can last longer and prioritize my time in a way that I don't get caught up in, Oh, I've got to stay an extra hour to get this paperwork done. Do I? Because it will be there tomorrow. If I clear the desk today, there'll be a new pile tomorrow. And that's the nature of our work. And I thought that that was, for me, a powerful breakthrough and something I encourage people and teach people to adapt, to understand and release the need to try to catch up.

There is no catching up in our field, we work in systems that are horribly upside down and not catering toward making sure everything is perfect for everyone. There is no catching up. And once I released the need to catch up, I focused on how can I live out a value, how can I get back to my mission as to why I do the work I do? And if I'm able to do that, that is a success versus catching up on what's going on in the world around me. So those are a few, just to kind of get us started of how I started shifting my mind and how I looked at work differently.

Cat McDonald:
Yeah, I was going to say those are huge mindset shifts, really.

Kelley Bonner:
Yes.

Cat McDonald:
So I wanted to ask you about changes that you've seen in your practice over the past year, what you might be seeing or doing now that was different a year ago?

Kelley Bonner:
I've never had anybody care about burnout like they do now. The fact that MIT and Harvard reached out to me and said, we need you to come in and do, I've never seen that kind of outreach from companies before on specifically burnout. Not other things, like burnout. Like, we need to be able to help people. Burn out, help us. Nobody was even languaging that until like a year ago. And now everybody's like, I think we're all burned out. I think we all need some burnout, yeah. Yeah, you do. And that never happened before. I've been certified in this for like five years now and nobody ever cared. It was like, no, you really should care about it. No, it's fine. And then last year everyone started being like, can you come talk about this? Can you walk us through this? Can you work with our people on this? That never happened before.

Cat McDonald:
Hopefully people are understanding that they really do need to take care of themselves, like they just have no choice.

Kelley Bonner:
Yes, I think the other thing that's really important to realize is we need to give ourselves a lot of compassion because this year has been like no other in our lifetimes, in the sense that a lot of times in the past, we may deal with people and work with people who are experiencing something we've never experienced or haven't experienced in a long time, or got through already. And yet, here I am now working with people, I'm in the same situation as all of them. You know, COVID particularly, is an equalizer in a lot of ways, in the sense that we are now dealing with the same stressors that the people we work with are dealing with, on top of whatever else may have been bringing them.

So a lot of adjustments had to be made on acknowledging that, that I am struggling too, just like everybody else, and that's okay. But it also required me to change up how I do things, to take regular breaks more than I did in the past, to acknowledge that virtual or in-clinic experiences are going to be different because now we're wearing masks and we're not all vaccinated yet. And so it has been an adjustment that way. But again, being very clear about that one mindset shift, that there is no catching up, I don't have the pressure to do that. And also developing a really great self-care kind of practice, I'm big on that. That was one thing that I stepped up even more in the past year because I needed to make sure I was working from a place of connection and authenticity, and I couldn't do that unless I was taking care of myself first.

And I highly encourage people when they do self care that it doesn't have to be expensive or time consuming, it can be less than 15 minutes a day and it can be for free, but that it has to include a lot of the principles and like the pillars of self-care. There's several of them. You have to take care of your body, you have to have physical self-care, you have to have mental self-care to care for your mind. You have to have emotional or self care around your heart, self-care connecting yourself to the spiritual, and that doesn't mean religion, it just means connecting to something bigger than yourself, whether it's participation in the arts or meditation.

And then finally you have to build really great self-care for your job, which that included beautifying my virtual space when I was working in an office and then now working from home. I make my table as pretty as possible even if it doubles as the dining room table, I try to make that nice. If I'm in an office and I'm having a one-on-one confidential session, making sure the office looks great. Lunch breaks, scheduling them in, otherwise you have the temptation to just keep going, going, going, especially if you're in a virtual setting, because now you don't have to walk anywhere, you don't have to go anywhere and so you find yourself glued to your seat. And so I made sure to build in wellness breaks as well. And that has been a big change for me, really sharing those things up and this new kind of post-COVID life.

Cat McDonald:
Yeah, you talk on your website about meaningful self-care, and it sounds like you're looking at all the different areas of the self, not just a bubble bath, but also ... I love that idea of self-care around your heart. Can you talk about that?

Kelley Bonner:
Yeah. It's really taking care of your emotions, and I love the word meaningful because it's not that I'm saying don't do a bubble bath, I'm huge into that, right? I'm not saying not to get a massage or take a vacation or any of those things, but often we forget the little things are what are actually really meaningful self-care. And when it comes to self-care around the heart, it really is about connecting back to your emotions. And as we know with any trauma work, the first thing that happens when people are slowly worn down and in the presence of pain, is you disconnect, you emotionally check out. Many a times and checked out mentally from a conversation, from a connection.

Some practical ways to do self-care for the heart can be having a good cry. Like I know that there are certain things and movies that I watch that when I am looking for a way to have a release, that's what I will do. It can be doing an act of kindness for others. Also, self-care for the heart is about emotionally connecting to someone outside of ourselves in a very positive way. Being kind, what are some of the things that we can do for others that will help them? It can be laughter. Anything that engages your emotions is something that you want to be doing. And also I'd say, having your pets and having time with your pets is self-care for the heart, because it's a connection, it is emotion based. Animals are very therapeutic and if you have an animal, make sure you're spending time with that animal. If you have a partner or a person, make sure if you can in this environment, if you have someone in your house and in your pod, that you're getting hugs from them. That's all part of self-care for the heart.

Cat McDonald:
Mm-hmm (affirmative).

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Cat McDonald:
Many experts are telling us that America is in the middle of a mental health crisis. How do you see that affecting social workers individually and as a profession?

Kelley Bonner:
Heavily. We are experiencing traumatic and stressful times alongside the people we work with, which is unique, that's not something that globally happens typically. And so the toll on the general public is, of course, visible. People are increasingly anxious and depressed, but I would say multiply that, and then you have first responders and mental health professionals who are on the line, working with the people who are heightened in their anxiety and depression. And so it's affecting us, like we are also anxious and worried about what's going to happen next.

And for the last year, we've definitely been wondering that, right? Where is this going? What is this new normal? Our world has significantly shifted. We are more isolated than we've ever been, and so I think our professions were already in a self-care, I think our professions in the self-care crisis. But it is even more heightened as we add this pandemic in the backdrop of how it's impacting the mental health of professionals like us every day, as we try to go out there and give to people but we're also trying to give to ourselves.

Cat McDonald:
So what practical advice do you have for anyone who feels that they might be on the verge of burning out?

Kelley Bonner:
So, if you feel like you're on the verge, you probably are burned out. Not to be negative, but one of the things I realized is that people, when they language and they start going, I think I'm burned out, it's like, you probably have been burned out all along, you just didn't realize it. That doesn't mean you can't do anything about it, it's just understanding that a lot of times, the way we see burnout is we think we have to be, like I told you my story about being in a puddle on the floor and crying and saying, I got to get out of this job, we think that's burnout.

But burnout truly and honestly happened to me six months before that, a year before that. I was still performing, I was still doing all the things, I was able to keep it together, but I was evidencing signs of burnout like a year before I actually thought I burned out. And that was when I was just exhibiting really over the top symptoms. One of the things to do, I would say for people who feel that way, is immediately start learning some skills for self-regulation. The first foundational step I teach people when they are either on the verge of burnout, let's say they truly are and it's preventative still, and then people who are in the throws of burnout in the more extreme versions of how it manifests, is I teach them how to self regulate their body.

One way I teach them to do that is by really quick exercises that shift people from that kind of fight or flight tension in the body that we have. That's one of the things that you start noticing, you're tense all the time carrying it through work, and shift them to more relaxed body posture. There's a couple of ways to do that, but what's key about self-regulation versus relaxation is that self-regulation can be done in 30 seconds or less, and versus relaxation, which also does the same goals, is a longer meditation or yoga. They take more time, but I teach people to self-regulate their bodies while in session. They can be working on self-regulation while running errands. Like they're working on self-regulation.

And a lot of that has to do with making your body go into relaxed posture, and that has to do a lot with the vagus nerve and really honestly, your pelvic muscles, releasing your pelvic muscles for women, this is much more easier than men, and unclenching in that area. And just relaxing that, I teach specific skills on how to do that, but unclenching that area of your body, there's something about that that just sends your body right. Like your shoulders drop, you adopt a relaxed posture and you can do it pretty quickly. So I teach people, one, getting into a relaxed body is key. How you do that, whether quickly or if you have the time to do it in a longer stint, and you practice yoga or practice some kind of meditation or something that calms you, guided body scans, things of that nature, any of that will be useful and get the job done.

The second thing after you've kind of gotten yourself into that calm body, is that you want to then start reconnecting to getting clear about why am I here and doing what I'm doing? And you start actively focusing on what are my goals of coming into practice? Where am I not being true to that? Because the other thing you realize is when you're burned out, we start betraying ourselves and betraying our values and principles. And that doesn't mean we're doing ethically wrong things, that doesn't mean that we now have to lose our license. No, no, no. That just means in small ways, we are compromising who we are and that pain contributes to burnout. So often I phrase burnout as a betrayal of yourself. So it's my goal to be compassionate and that's what brought me to this work. And then I find myself wanting to tell off everybody in my peer group, people I work with, everybody. I'm just short fused and I'm thinking negative things and I'm angry. And I'm using the language of sarcasm like in a weaponized form, like I'm harming people with it. That's not good. That means I'm going to burn out. Like that's not a good sign.

And so I want to get back to compassion and I start giving myself like, how am I going to show that in three ways today so that I am present and aware? And then I step back into those self-care principles as well, like immediately. What can I do in 15 minutes or less that is self-care for my soul? Is it practicing gratitude, writing down things I'm grateful for, self-care for the heart? Is it spending time laughing or having a release, an emotional release through tears? What can I do with those principles to get me back in shape? So it's a combination of relaxing my body, reconnecting to what's important to me and what brought me to this work, and then getting in some really good self-care.

I think it's important to acknowledge that these are all great things and they take time to implement and take time to put into practice. But once you do, they pay off. And the thing that most people don't realize is, they pass really quickly, even just the self-care pillars. If you are spending time to write a gratitude list, which can take you less than five minutes, right? If you are spending time to connect with people, have a meaningful conversation that brings you joy, or do one small kind of act a day for somebody, even if it's just sending a text message saying, I'm thinking about you. I'm all about doing really small things that do have big impacts. So you don't feel overwhelmed like, Oh, I got to start a self-care practice on top of all the other things. I'm a partner, I'm a parent, I'm a caregiver. And you want me to do self-care?

No, I want you to do it in really small, reasonable steps. Self-care for your body, everybody goes to exercise and diet. Yes, three times a week you need to move your body, that's just a fact. However, if that's a struggle for you, self-care for the body is just wearing something you love. What's your favorite outfit that makes you feel empowered? That's something that takes you, what 30 seconds to decide to do and then wear? These things do bring healing and they do bring you out of burnout, and they do prevent you from getting there when it becomes your routine.

So by no means, is anyone asking you to make some big steps, huge decisions, life changes, spend a lot of money, but rather work in small ways to establish a routine. Work in small ways to tackle, what matters to me? Why do I love what I do? Writing that down on a sticky note, nothing really over the top or time intensive, because the bottom line is when you're burned out, the last thing you want is homework assignments that take you hours, or that make you think deeply into your childhood or whatever that is, right? You want something that's light, that's doable, that brings you joy pretty quickly. Dwelling on what you love about your work should bring you joy. Dwelling on something that makes you feel good and doing a kind act for someone sparks that joy back. Wearing your favorite outfit makes you smile and makes you feel empowered. Those are the things that start you on the path back if you're already burned out or keep you from ever getting there.

Cat McDonald:
Anything you wanted to add or anything I should have asked you?

Kelley Bonner:
Oh yeah. I would say one thing I would want to add is find your community. I'm trying to self-regulate, I'm trying to do self-care, I'm trying to find what my mission is, what is my goal in life? What's my purpose of being here and doing this work? But what heightens that is having a good community around you and having good supports. And I always tell people, social supports are not necessarily your friends. They can be, but it's not a requirement. A social support is simply someone who holds you accountable, lovingly, and helps create the kind of vision for yourself that you want.

So if you tell someone, you know, I really want to work on practicing from a place of integrity and I want to be more present with my family, that's my goal. I want to be a more present person. Then you train your support to hold you accountable when they notice that you're not doing those things. And that also, with your support, that you identify with the people who can handle listening to you vent, you have vent sessions. You talk about a particularly difficult client or person that you've worked with. And what's, you know, bringing things up for you, or if it's a painful, if you sat in the presence of pain that's bothering you.

Or you talk about how you're frustrated about some new protocol at work, and you get it all out and your support simply helps and guides you back to, I hear validates everything you say, but also can redirect you to say so, again, why do you love what you do? Well, it gives me an opportunity to practice with compassion or practice to connect with people and help have meaningful connections. Okay, so are you able to do that and how can you make sure you're bringing that in? So, training community and having social supports with each other, to make a promise with each other to check in and remind each other what your values are, are great to check in and make sure you're doing some self-care. And like, let's do some self-care together, let's, you know, find something that makes us laugh and pass around a funny YouTube clip, right. That also helps reaffirm and keep you consistent in a practice that prevents burnout.

Cat McDonald:
Thank you for that. And yeah, thank you so much for being our guest today.

Kelley Bonner:
Thank you for having me, I was thrilled to be here.

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