Helping professionals often choose their work for one noble reason: to help people. When all goes well, helping can be a deeply fulfilling experience, giving professionals a sense that they lead meaningful lives. It is what motivates us to work the long hours, to pay for the extra training, to take on the extra patient.
However, “helping people” may start to feel like an insufficient goal when professionals are, in fact, unable to help. What happens to that sense of purpose when a therapist loses their client to suicide? Or the social worker can’t find one single foster family to house a child in need? What happens when the emergency room is at capacity and people keep pouring through the doors?
This year, health care workers have been stretched to the breaking point by the COVID-19 pandemic. Doctors and nurses have witnessed an exponential death toll of their patients, colleagues, family, and friends. Therapists have comforted clients through a computer screen, counseling on coping with a still-in-progress crisis. The old adages from our training don’t apply anymore: we can’t leave work at work. The work has permeated our lives.
Increasingly, people in the field are becoming aware of the darker and more difficult side of caring for others—caregiver strain. Caregiver strain shows up in places where helping professionals feel overburdened, ineffective, and unappreciated. Unfortunately, helping professionals often suffer in silence, out of fear that their colleagues will see them as weak or ineffective.
This stigma around caregiver strain only isolates the helper in a double bind. Their agency may advise practicing self-care, while setting them up with a workload that renders self-care at best, ineffective and at worst, impossible. The burdened professional plows forward in misery until they are forced to stop working for the sake of their career, health, or sanity.
Loss of Meaning
On a deeper level, caregiver strain can shake a helper’s belief that they do meaningful work in a benevolent world. This loss of meaning may be one of the steepest costs of caregiver strain. It robs the helper of their very identity as one who works for the greater good.
As anyone who works in a helping profession will tell you: the work we do is not easy. Professionals need a compelling reason to keep showing up to work each day. If their personal mission has dissolved under an onslaught of vicarious trauma, motivation for the work could quickly desert them.
Reframing Beliefs About Suffering
In order to stay resilient in the face of trauma, helping professionals may need to examine their personal beliefs about suffering. For example, if you were raised to believe that good deeds are rewarded with happiness, and that we are never faced with more adversity than we can handle, you may find it impossible to make sense of what you see at work. The unfairness of death, the senselessness of violence – these don’t fit neatly into a world view where good things happen to good people.
Americans are raised with a transactional view of life, where hard work pays off in prosperity and harmony. American helping professionals are steeped in this culture. We believe that if we could just work hard enough, say the right thing, deliver the right treatment, we could deliver our patients into happy futures. It can be quite difficult to come to terms with the fact that this is often simply impossible. And when failures outweigh successes, helpers can find their resource of compassion souring into bitterness.
More than ever, we need to understand our own limitations when it comes to helping. We need a philosophical world view that can allow for the unfair, the unexpected, the heartbreaking. A robust, flexible, transformed sense of meaning could be an essential protective factor against caregiver strain.
Rather than skirting the issue of suffering with professional platitudes, we need to examine it unflinchingly. Helping professionals might consider turning towards an unexpected source for comfort: philosophical and spiritual wisdom. Buddhist philosophy, for example, places the expectation of pain at its core. It teaches that suffering is not an aberration, or a punishment, but a normal, expected part of life — just as much as love or joy or taxes.
When we see illness and pain on our doorstep, we believe that they have the wrong address. It is this resistance to pain – our belief that it is undeserved – that robs us of our ability to cope. Buddhist philosophy encourages us to accept pain and loss, not only because it is unavoidable, but because it unites us with all living beings. Not one single person can make all the right choices to exempt ourselves from pain. It is our central work as humans to learn to endure suffering, because suffering gifts us with compassion, and compassion allows us to be present when others are in pain.
Redefining Your Purpose
The identity of a helping professional needs a makeover. Of course, we will continue to strive to help everyone we can. But professionals must truly accept that like our patients, we are only human, and therefore deeply imperfect. And perhaps, accepting our vulnerability can be the basis of a new kind of purpose.
For example, instead of helping people, our core purpose may be to simply accompany people through their suffering. This, as helping professionals, could be our most profound gift – not our training, not our education – but our ability to hold space for the fragility of life. Our purpose may be to simply do our best to be kind, while we work diligently with our imperfect tools.
Focusing on the Collective, Not the Individual
While internal transformation can be a protective factor against caregiver strain, it is an incomplete solution. Caregiver strain cannot simply be framed as an individual problem, where the onus is on the individual to stay healthy by managing their response to feeling overwhelmed. This way of thinking only engenders shame and guilt in professionals when they find themselves experiencing real, human emotions in response to witnessing terrible events.
The helping field needs to take a hard look, not just at the world, but at the systems that overwhelm the helper. What of the structures that assign professionals three times their caseload, then send them home with meager pay and vague prescriptions for self-care? Can fresh beliefs truly sustain workers when their labor is exploited by an indifferent system?
Instead, let us share the responsibility for sustaining the health of helping professionals. We need systems that understand and allow for our humanity, our imperfections, our vulnerability. Let us consider building systems that respect and care for the dignity of the helpers, as well as the patients. In this way, we carry collective responsibility to care for each other, rather than suffering individually in silos of caregiver strain.