Helping people is hard work.
It can be especially hard if you are a helping professional. No matter what setting you work in, whether it’s a hospital, clinic, or private practice, you will likely encounter deep suffering every day. It’s in the nature of the business. People rarely come to us with simple, easy-to-solve problems. More often they bring lifetimes of secret hurts and private struggles.
To support these folks, your most important tool is yourself. There is no way to help people from a distance. You have to be right there with them, hearing their stories and responding compassionately. But if you’re going to last in this profession, you have to listen and intervene without allowing yourself to be buried under what you see and hear every day. Stress and burnout are always just around the corner.
When I started in the field of social work, I worked at a community mental health center just outside of Boston. It was amazing early career training – I got to work with people from all walks of life who brought with them the full spectrum of human suffering. I am forever grateful for the lessons they taught me.
Many of my clients had histories of trauma. Intellectually, I was prepared for this work. I had read everything I could about trauma. But, emotionally, I was just getting started. When I talked to clients about traumatic experiences, I would encounter a weird, disconnected, numb feeling inside. After a session, I would notice that I was irritable and tired, and that I couldn’t really access the full range of my emotions. I would expect to feel something more palpable, like sadness or anger, but I felt neither. I referred to this state as “emotional constipation.”
At night, it was a different story. After being asleep for a few hours, I would wake up filled with rage. I wouldn’t realize I was awake at first. But then it would dawn on me that I was lying in bed, gritting my teeth, staring at the ceiling, and bursting with anger. At first I had no idea where it came from. And I didn’t know what to do with it. It scared me a little bit. What was my job doing to me?
It didn’t take long, however, to make a connection between my emotional constipation during the day and my late-night rage. Though I hadn’t yet stumbled onto acceptance and commitment therapy (ACT), which eventually became my professional focus, I was intrigued by the idea of acceptance, and I had found the willing and open space I had discovered through mindfulness practice personally meaningful. I wondered how I could practice acceptance with this anger.
Accepting the Hurt in the Service of What Matters Most
I began to anticipate my midnight rages. I would say to myself after a particularly difficult session, “Well, it looks like I’m going to wake up in middle the night tonight.” And when I did wake up, I validated it as a natural byproduct of supporting my clients in recovering from traumatic experiences.
I began to see it as the cost of doing business. I had been given this great gift: people trusted me to hear their stories and bear witness to their pain. Waking up in the middle of the night, full of rage, was what came along with that gift. I recognized the rage as a normal human reaction to injustice and exploitation. It began to feel justified, right, and even holy. It told me I had a heart.
This practice had an interesting effect. Over time, the midnight rages stopped showing up, and the anger and sadness I had expected to feel in response to my clients’ stories started emerging in the moment while my clients talked. Around this time, I discovered ACT. Drawing on the skills I learned from the ACT tradition, I would imagine breathing in and out of this anger and sadness, cradling it lightly like a butterfly, or gently wrapping my arms around it like I might hold an infant.
The result of this practice was that the anger and sadness felt much less overwhelming. It just felt like my natural experience. And by the end of the session, or the end of the day, it would usually dissipate rather than follow me around into the evening.
Adding Values to Acceptance
As I got more deeply into ACT, I discovered the power of adding values to my mindfulness and acceptance practices. These days I cultivate a practice of articulating what’s most important to me in the form of how I want to be or act on an ongoing basis.
That’s all a value is in ACT: a statement of how you want to live your life from moment to moment.
Recently, during a difficult time related to balancing a heavy workload, negotiating personal obligations, and managing a chronic illness, I wrote out this list in my electronic diary:
I want to be a person who:
– Embraces new experience, uncertainty, and the unknown
– Welcomes others with curiosity and without judgment
– Loves his partner unconditionally. Loves his family and his friends with his whole heart.
– Remains connected to the spirit
– Practices being mindful of experience so as not to miss out on the richness of life
– Practices effective self-care – sleeping, eating, and moving my body in a way that optimizes my ability to experience life, have fun, and engage.
– Pays attention to the bigger picture – the community, the world, what’s going on outside his immediate environment
– Treats himself with compassion, acceptance, and love
– Has unabashed, unfettered fun. Plays with the absorbed abandon of his childhood self.
For the past few months, this list has become something of a mission statement for me. I consult it at the beginning of almost every day to remind myself how I want to show up in the world.
Notice that all of these bullets describe actions. They are not thoughts, feelings, sensations or urges. From the ACT perspective, our immediate reactions are largely outside of our control. But what we do is almost always in our control. In this way, who we are can be a choice.
So when I’m feeling run down, burned out, or out of control with my life, I use this list to guide me. If I wake up dreading the day ahead, I might start the day by looking the list over and reminding myself of these choice possibilities.
I might imagine the upcoming day and identify (and write down) potential opportunities for putting these values into practice. “I have plans to go see some music after work. That’s a good opportunity to embrace new experience and really dive into having fun.” “I’m going to have a meeting with a colleague I don’t really connect with at 1 PM. That’s a good opportunity to welcome this person with curiosity and without judgment and see what happens.” “I’m going to savor my morning tea to really embrace the gift of comfort, flavor, and familiarity it provides.” “Maybe I’ll call my mom today.”
The effect of this is that I stop focusing so much on my worries about the day (though they certainly linger), and instead I focus on the opportunities available to me to embody this person I’m choosing to be. A familiar metaphor in ACT is that values are like a compass pointing you the right direction. It really fits. These actions are the directions I want to move in. Sometimes I will move in them, sometimes I won’t. But I can always remind myself of the course I have plotted. And when I step away, I can notice that this has happened, treat myself with compassion, and turn back toward what’s important.
Putting It All Together
When I’m focusing on this bigger picture, my worries about my day have less impact, less power. They don’t rule me so much, and my mind focuses less on them. They still hang around. However, ACT isn’t about making discomfort go away. It is, after all, called acceptance and commitment therapy. But I begin to see them as part of a bigger picture, just one facet of a complicated me. I am the one who loves his partner unconditionally and loves his family and friends with his whole heart. And I’m also the one who is filled with worry sometimes. I can be all of this. None of it is the sum of me. And the worry becomes something I can carry just a little bit more lightly while my life continues to be rich and meaningful.