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Burning out on Postdoc -- What to do?

Discussion in 'Psychology [Psy.D. / Ph.D.]' started by Groupthink, Oct 18, 2017.

  1. Groupthink

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    Warning: rant thread. tl;dr at bottom

    I feel like it is too early in my career to feel this tired. I am exhausted every morning, dreadful and irritable about going to work. I am seeing at least 6 clients a day, oftentimes more, and usually called into triage situations to put out fires.

    I have an excellent workplace with great benefits and colleagues who keep me on my toes. We are always learning, and I accepted an offer to become permanent staff once I am licensed.

    Yet I get home at 6 PM every day and sit on my couch exhausted with no energy to do anything. I try to relax and I can't. Before I know it it's time to go to bed, which just means it's time to wake up again and see more clients.

    I never felt this way during graduate school. Back then, I was taking classes, doing research, clinical work, and managing a job every single day. I would work 8 to 8, didn't have weekends, I didn't take vacations, I got my dissertation done early. I had energy and woke up every day ready to tackle the next thing on my list, and felt accomplished every day.

    I have no idea where my energy went. Maybe it's because I haven't cleared the EPPP yet and that is hanging over my head. But somehow I don't think that is the issue.

    I have talked to other colleagues who 1. feel the same way this year, because our community health center's marketing department has done vast outreach and we have 150% of the clients coming in this year compared to last year but fewer staff to handle them all, and 2. keep telling me that maybe I thrive more in environments where I am doing more than therapy.

    I really don't think #2 is accurate, because right now I dread the idea of going back to balancing so many things at once.

    I thought maybe I am sick, but the doc says I'm in good physical health. Maybe this is just good old depression setting in.

    What am I supposed to do? I know I am not being present enough for my clients, or for me. I have tried taking vacations, tried working on hobbies, but I am just too tired. My sleep hygiene is A+++, bed at 10, wake at 6:30. I am falling asleep in sessions, finding myself judging my clients internally, and falling behind on paperwork in a way I never have before.

    I never expected to feel this way so early on in my career. What do I do?

    tl;dr Tired all the time, increased demand at work without the staff to meet it, trying all the self-care stuff but it's not working; EPPP is hanging over my head but that will get done; im clearly not at my best with my clients and this needs to be fixed
     
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  3. MamaPhD

    MamaPhD Psychologist, Academic Medical Center
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    Yep, sounds a lot like burnout. Some thoughts:

    That's a lot to manage 5 days a week. No amount of self-care is going to erase the "do more with less" situation you're in. I was about to say something along the lines of, "focus on the light at the end of the tunnel" but then I saw:

    :lame:

    ...why?

    Perhaps you are having some misgivings about committing to this place long term? On another note:

    I'm having trouble reconciling this with your description of grad school. As we all know, thinking of something with dread does not necessarily portend bad things.
     
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  4. foreverbull

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    I actually don't think what you're experiencing is entirely uncommon; multiple people have mentioned serious burnout in here once at the internship/postdoc stage. Sometimes we get so caught up in just getting to the goal that we don't have time to stop and reflect on whether it's going to be a good fit when it's 40+ hours per week of the same thing, and we don't ever get to test that out until internship....at the very end of our program. This thread posted by someone with similar feelings gets at some of what you're experiencing:
    Too late for second thoughts?

    Given that your concerns seem to be affecting your work with clients, I'd suggest seeking therapy. If taking care of yourself means therapy and/or taking a sick day here and there to recharge, so be it. If you're at the beginning of your postdoc and this is where you're already at (you didn't specify), it sounds a bit concerning. If this place isn't a good longterm fit, you need to consider other options. You said it doesn't sound appealing to try to do different things, but you may feel differently about it in the future. You might find that private practice, adjunct teaching, supervision, etc. are things that you may need to create for yourself if the 9-5 organization job isn't going to work...or maybe you just need to move away from the kind of job you have now and find something different.

    Like you, I entered my postdoc thinking I'd do a regular 9-5 and quickly realized it wasn't the right fit, and feeling stuck in a job that I knew wasn't a good fit drained me as well (I also hadn't taken the EPPP yet, but that wasn't as much of a factor in my stress). I gave notice when I knew when I'd get my hours, and then left (my postdoc didn't have an end date and I wasn't contracted).

    You might need to take a step back and reflect on what you need both in the short-term and the longterm. Taking some time to reflect when you're rested and clear-minded is a good start....and you can also sort it out with a therapist, which I would encourage to get an objective perspective.
     
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  5. cara susanna

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    Obviously this is not a permanent solution, but can you take a mental health day or some vacation time? I'm in my first full time psychologist gig and that Monday to Friday slog, without any breaks, really drains you.
     
  6. Therapist4Chnge

    Therapist4Chnge Neuropsych Ninja Faculty
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    Going from 10-20hr/wk of practicum to 40hr/wk internship to 40-50hr/wk can be rough bc the F2F time likely kept going up. Others have touched on self care, securing your own therapy, etc...all excellent advice. Best of luck.
     
  7. PSYDR

    PSYDR Psychologist

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    On the PsyDr burn out scale, this is a 1. It's a relatively easy thing to fix but it requires some effort. At this level, the stress from a job is draining. The person gets home and feels exhausted, so they sit around which results in poor sleep quality and eventual physical de-conditioning. The fix is to fight against this by scheduling your time and doing the opposite of what you want.

    1) For the love of god, find at least 2-3 regularly scheduled activities. Ideally 3+.
    2) Once you get something to do 2-3 times per week on weekdays, you have some time crunch to actually get life BS done.
    3) When you are home, do something. Go for a run, cook a complex meal, whatever. Watching tv does not count.
    4) If you are not partnered, start dating.
    5) That thing that "looms" over you? Schedule 20 minutes/day to do it. No more. Take a long bath and read, listen to an MP3 while running, read while sitting in your laundry room. Do not do more than that right now. Easier to create a habit and modify it later than the converse.
     
  8. oathkeeper

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    I had a really hard time with this on post doc too- found myself burning out by seeing 25+ patients a week. My first year after post doc, I made an effort to try to find a balance of clinical work, researching, supervising and assessment. It's helped a lot. I also realized that they client population I was seeing on post doc was not a good fit for me. I was on a DBT team and the 24 hour coach calls made me MISERABLE. Realizing my own limits and then working around them was helpful. It's still a work in progress and I'm not 100% content with the balance I have now, but figure I'll just keep working towards finding the best fit for me!
     
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  9. hillies

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    I experienced the same thing on fellowship. One thing that really helped me was regularly scheduling happy hours, lunches, or dinners with colleagues to get the heck outta dodge at a reasonable time and have fun doing it -- we all had similar feelings about the volume of work too, so it was helpful to feel understood by them.

    I know this is going to sound counterintuitive, but I also started meal prepping and that helped a lot. I would spend most of the day either Saturday or Sunday shopping and cooking/prepping most of the dinners for the week. I don't particularly enjoy cooking on a time crunch, so for me, coming home to that every day made things even worse. But having food ready to go really freed me up to go read for fun, go for a bike ride, meet friends...whatever I wanted to do to unwind. And I think it helped reduce the emotional energy associated with coming home so my home was a lighter, happier place to be for me.

    I also started walking with a colleague during my normal lunch breaks. A full hour a few times a week. That really helped break up the day, and even if I was seeing 6-10 patients in a day it would help me feel like more of a sane person at the end of the day. It was also good to have non-therapy conversation and just laugh and get some fresh air and sunshine. When you're working long hours and feel like you never see the sun, this can make a big difference.

    And lastly, it gets better. Or it should. And if it doesn't, you may want to reconsider working there. You've worked far too hard, for too long, to hate what you do now. Find a setting that better suits you if things don't change quickly after fellowship. For me, I knew that the setting I was working in--despite loving my colleagues and the work I was doing--was taking a toll on me physically and emotionally. I got sick many times throughout the year (pneumonia?! bronchitis?! what?!), even though I normally go 3 or 4 years between colds. I found a different setting doing the same type of work and I am much happier with the balance I have now, despite having to move away from my friends and familiar surroundings. I hope things get better for you soon.
     
  10. Harry3990

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    Alright, well now I'm curious what the PsyDr burn out scale looks like at levels above 1. Care to share?
     
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  11. Therapist4Chnge

    Therapist4Chnge Neuropsych Ninja Faculty
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    :laugh:

    Based on posts in the past, he keeps himself (very) busy...so it may skew high.
     
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  12. G Costanza

    G Costanza Psychologist - Private Practice

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    How much does your supervisor know about this and what are they doing to be supportive? If they don't know anything, we have a problem.
     
  13. mlwg1

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    I really relate to this post. I had serious burnout during my VA fellowship. I took a lot sick days of too, though in general I'm not one to get sick. I had various physical illnesses but also a fair amount of mental health days to regroup.

    Ultimately, the experience provided the push I needed to realize that full time clinical work wasn't for me. I networked my butt off all year and now I'm in a research position that I absolutely love. So in addition to talking all the wonderful self care tips above, do some soul searching to figure out what exactly is burning you out. That way you can do your best to build your career accordingly.
     
  14. erg923

    erg923 Regional Clinical Officer, Cenpatico National

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    Seeing patients (especially in an exclusively therapy/intervention based position) 40/week for is grueling! Not to mention doing this for 20-30 years! Some people are built for this, and some people aren't. I wonder if we do not talk about this enough in training, especially at the internship and post-doc stages? I'm not sure if all the droning on (which I how I perceived in my training days) about "self care" really addresses the reality of this?

    Do all the "self care" you want...it doesn't change the systems we have to work in, it doesn't change the larger societal dysfunction and issues that limit our power and test our patience, and it does't raise your salary. Which, if you are in a strictly clinical position, may not be what you really thought it was going to be. It doesn't change the fact that the dysfunction and neediness of patients can be annoying at times. It doesn't change the fact that you are around alot of unhappiness and/or psychic suffering most of your work day. It doesn't change the fact that you simply may prefer to do something else within healthcare or psychology. Or, that you may be happier as a plumber.

    When I finally got into my jam at the VA, I lasted about 3-4 years before I came to the conclusion that I simply could not sustain that role for another 25 years. So, I left.
     
    #13 erg923, Oct 20, 2017
    Last edited: Dec 4, 2017
  15. Rivi

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    I like the advice from the posters above me.

    I have found exercise to be VERY helpful as well in addressing energy and fatigue, and would encourage you to do this if you haven't already.

    6 patients a day is a lot for post doc IMO, especially if they are acute. I think anyone in your position would be feeling what you are feeling. The good news is that you will grow into this job/full-time clinic work, and I expect that some of this will improve as time goes on.

    There is a pretty good book titled: Leaving It at the Office by John Norcross that addresses self-care that you may find helpful as well.
     
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  17. cara susanna

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    I totally agree with you. I think the issue is that, with all of the pressure and focus on only numbers, providers are being pushed beyond their limits as human beings. Maybe some people are built to see that many patients per week, but that doesn't mean it's healthy for them overall. I don't know the solution, really. At least in the VA you can take on additional diverse duties or responsibilities that reduce your expected face-to-face time. I'm not sure what to recommend for providers outside of it.

    This is actually one of the reasons I'm switching to general work (from a PTSD position). Even though I love PE and CPT, I've realized how burnt out I would get with 30 hrs of nothing but that.
     
  18. temppsych123

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    This may be better off as a new thread, but I'm seeing so much of myself in the above descriptions of being burnt out, except I'm in a research-focused postdoc. My clinical responsibilities are limited, and I find that I enjoy them much more than the slog of research (which I used to love!). There's lots of other external factors going on that contribute to this burnout feeling, but I'm wondering how other people manage to figure out the difference between temporary burnout and a more permanent realization that the career you thought you wanted isn't the one you're cut out for?
     
  19. erg923

    erg923 Regional Clinical Officer, Cenpatico National

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    Not sure if there is a real process or technique. For me, it was just brutal self honesty. I just did not enjoy doing it anymore. That's not to say I hated it or that loathed seeing my patients. But, it was something that I didn't enjoy much anymore, and I didn't want it to be my career for the next 20-30 years. I grew increasingly frustrated with the VA healthcare system as well.

    As a concrete example, when you work in the VA, there's always tons of training opportunities thrown your way for different therapies, knowledge updates and lectures. I found myself uninterested or not curious about them most of the time. That became alarming when it went on for months and months and months.

    Another example, and there is a thread in psychiatry right now about this: 1. The psychiatrizing of emotional/social dysfunction within the American healthcare system is frustrating and concerning. It was like swimming upstream with this (overtreatment is also a problem in the VA), and I didn't enjoy confronting people with this reality time after time. 2. I found alot of the presenting concerns/symptoms in my clinic boring. Insomnia is boring to me. "Irritability" is boring to me. And by the way, when the **** did "irritability" become such a ubiquitous psych complaint? I didn't enjoy coaching people on how to be nicer to their spouses and children.
     
    #17 erg923, Oct 21, 2017
    Last edited: Oct 21, 2017
  20. G Costanza

    G Costanza Psychologist - Private Practice

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    I'm in the same boat. I'm increasingly fed up with the political garbage at UCCs and going to try private practice soon. But I'm also wondering if I'll enjoy that less and less and either go do something else entirely, or find another way to use my degree.
     
  21. foreverbull

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    Some questions you might want ask yourself:
    1. Would I feel differently if I didn't work with these colleagues/supervisors or wasn't in training?
    2. Would I feel differently if my pay increased?
    3. Would I feel differently if I had different responsibilities and/or worked with less/more clients and/or different clientele?
    4. Are there any outside factors contributing to burnout/exhaustion (family issues, health issues, etc.)?
    5. Are my current job or outside factors likely to change in some significant way that will help me enjoy my work more?

    If you answer no to all but 3, and yes to 3, you might have a more permanent issue that your job can't fix if it doesn't offer flexibility in roles/responsibilities. As I've said before, I'm not sure about others' programs, but my program failed to prepare students for the realities of the changing job market and job prospects unless you were on the tenure-track route. It's unfortunate, because I think if they had simply pulled in practitioners/researchers to talk on a panel about their careers and roles/expectations and changes they've seen, it would have been really helpful, but I digress.

    At any rate, those are some questions to consider when determining temporary vs. longterm burnout with a job.
     
  22. ela

    ela

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    Could you say more about the political garbage?

    really feeling the burnnnnnnnnn here myself of late. . .
     
  23. G Costanza

    G Costanza Psychologist - Private Practice

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    Feel free to PM me for details. Just don't want to share too much on here.
     
    #21 G Costanza, Oct 24, 2017
    Last edited: Oct 24, 2017
  24. temppsych123

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    Such key questions! For me, it's 1) Yes (for one supervisor, not the others), 2) No, 3) Yes, 4) Oh dear lord yes, and 5) Unclear. Very hard to figure out how much of what I consider burnout is related to my current role versus a whole slew of other unpleasant life circumstances. Will keep pondering!
     
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  25. SirPsychAlot

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    I am in the same boat of being exhausted. Erg923 is right. It is grueling! I am wondering why #2 can't be so? I imagine you are thinking more about grad school level balancing, and I'm thinking that people are advising you to have other clinical opportunities that offer "direct clinical contact", but isn't therapy. For example, outreach programming, community consultations; which would allow you to break away from the therapist role a bit, but not necessarily require you to travel and scurry around, or necessarily add more hours to your workday. I think breaking up your day or some of your week may help with managing that.

    I, on the other hand, know that I have a maximum number of clients per day and week that I can tolerate before I begin to feel drained. I'm wondering if you have had an opportunity to notice what that number is for you?
     
  26. SirPsychAlot

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    Man, did this resonate with me! The clientele I am drawn to, I am also more readily drained by. So I have to have fewer clients in the long run in order to be effective for them; OR I can have more clients (and likely more income), but not be passionate about the clientele. I think I work the same way with research. The more invested I am in the topic. The more intense (and drained) I become about it. If I care less about the research, I can step in and out of it, clock in and out, much more readily.
     
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  27. SirPsychAlot

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    This tickled me. I mean, it does sound like shifting from being a therapist to a "coach" as you said, which can be frustrating... The psychopathologizing and psychiatrizing of certain traits/states can be frustrating. Sometimes it feels like I'm being asked to surgically remove personality factors someone perceives as unflattering. I'm not a cosmetic surgeon. I prefer going deeper to enact change.
     
  28. psy131

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    I am having a similar, yet slightly different experience. My burnout is real and very situational (#1, 3, 4=yes). I have talked to my postdoc site about my concerns, but it is unclear if things will change (#5). I am trying to look at all my options, but I don't know what my options are at this point. Any thoughts? I am even thinking about quitting, which is not something that is typical for me. Has anyone ever quit their postdoc or do you know of someone who quit? What ended up happening?
     
  29. foreverbull

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    I experienced massive burnout during internship (for many reasons, some of which being high level of micromanagement, high level of evaluation, unrealistic expectations, and very probing supervisors who believed we needed to share our personal lives with them to be considered good trainees. They liked us better after we broke down in tears during supervision/group supervision).
    I considered quitting at times, but kept reminding myself it'd be over if I could just keep my head down and finish. And I did finish, although it was difficult. I did have colleagues who were in it with me, which helped.

    That said, I still need letters and forms filled out from these folks to this day (2-3 years later) when I apply to jobs even though I'm licensed, so it's a good thing I stayed and I never said anything that would burn any professional bridges.

    I'm not sure about postdoc, but you are in a similar situation in which you are still in training and desperately needing hours for licensure, I'm guessing, so you really have to weigh whether it's worth it to walk away AND possibly burn that professional bridge for future letters of rec. You may also need to be prepared to explain to other sites why you were only at X site for a little while. It's not insurmountable, and if your mental health is in danger by sticking around, I'd say that should be the most important factor. But I'd look into therapy for sure, first, and consider if the light at the end of the tunnel of postdoc completion is just too far away for you to wait for. Sorry to hear that's been such a rough time!

    Any folks have luck finding another postdoc if they left their first?
     
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