Empathizing more selectively

[psychnpgirl]

For those of you who tend to absorb others' feelings, how did you learn to balance your empathic nature with self-differentiation, to have boundaries that are porous enough to be therapeutic but structured enough to protect yourself? I struggle with feeling patients' emotions too strongly, especially towards the end of the work day. In the last few days I've been exhausted and almost detached as a result.

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[thoffen]

I don't think it's necessarily about clinical technique. Sure you can get fatigued and affected by emotional situations and empathy in the work, but if there's difficulty with self-differentiation and understanding or maintenance of boundaries, then that's a different problem. I don't think there could be generic advice given, either. Probably best to seek direct supervision for these cases and build up your own observing ego.

 

[nitemagi]

When I supervise residents, I liken it to a teeter-totter. Get the feel for when you're leaning in too much (over-empathic) and when you're leaning back too much (apathetic). And combine that with "never working harder than your patient."

 

[Attending1985]

I struggle with this as well. I tend to get caught up with negative feelings when patients aren’t doing well. I try to remind myself that while I’m trying to help I am in no way responsible for the patient’s suffering.

 

[smalltownpsych]

I find that I can dive in pretty far as long as a I remember that I can find my way back and that my secondary experience is never really as bad as the patients primary experience. In other words, I have coping skills, support systems, cognitive strategies, that I have learned to utilize far better than any of my patients. In fact, that is part of why they come to me, to learn how to manage better so I better know how to do it. Also, I will always remind myself that hearing about childhood sexual abuse or other difficult traumas, a really tough one is parents who have lost a child, but it is not even close to as hard for me as it is for them. Final thought is that if you do this job well, then at the end of a tough week, you should feel exhausted. If every week is tough and you are always exhausted then there is a problem and as mentioned above, good supervision can help you resolve that. I was feeling exhausted much of the time the past few months because I decided to teach a class for fall and the extra workload pushed me right to my limit. So I turned them down when they asked, almost begged even, if I would do it again.

 

[deleted736562]

For those of you who tend to absorb others' feelings, how did you learn to balance your empathic nature with self-differentiation, to have boundaries that are porous enough to be therapeutic but structured enough to protect yourself? I struggle with feeling patients' emotions too strongly, especially towards the end of the work day. In the last few days I've been exhausted and almost detached as a result.

Boundaries are not only beneficial to "protect yoursef"; patients also benefit from structure and limit setting, which in many cases had not experienced when growing up. I think with time you reach a stage where you develop a certain skill of empathy without identification. You're able to emotionally understand what is going on without necessarily identifying with the patient and feeling like you're in the patient's shoes.