By Nataliya Schetchikova, PhD

As the year comes to a close, many people reflect on the accomplishments they’ve made and the obstacles they’ve overcome. Some feel the pride, gratitude and joy of having a happy family, enjoying a fulfilling career and contributing to society. Others will enthusiastically set goals for years to come. Yet, some may look back and feel tired, out of control, and confused about where to go from here.

While everyone occasionally goes through tough times, chiropractors and other healthcare providers may feel they cannot afford to do so. After all, they chose their profession so they could tirelessly and selflessly give to others. What’s worse, for many, giving doesn’t end in the clinic—their altruistic personalities compel them to take care of others in their personal lives, as well.

“Many of the people who go into the helping professions have been taking care of others since early childhood,” says Terry Eagan, MD, medical director at Moonview Sanctuary, a holistic mental health center in Santa Monica, Calif. “People came to them for support—and they gave it because they had a gift for helping others.”

Over time, however, constant giving backfires. “People in the helping professions often don’t know how not to give—or they give too much, to the point of compromising their personal lives,” says Jason Fierstein, MA, LPC, a counselor in Phoenix, Ariz., who has worked with healthcare professionals. By doing so, “they are wearing out their own gift of healing,” he says.

Are You Tired of Giving?

That’s what happened to Dr. Eagan. A psychiatrist in a busy practice who has always enjoyed his work, he started feeling run down, disinterested and irritable. “I dreaded seeing patients, resented the number of hours I worked, and developed a sour attitude,” he says.

Curious about what happened to him, Dr. Eagan started talking to other clinicians and people in helping professions—ministers, teachers and police officers—and found that many could relate to his symptoms. And although he didn’t find much literature on the subject, he realized that he was suffering from “compassion fatigue.”

“Those who provide a compassionate service can begin to take on some emotional residue, such as trauma, high anxiety or difficult life circumstances, from people they work with,” Dr. Eagan explains. Compounding the problem are doctors’ lifestyles—not taking vacations, lacking adequate sleep and exercise, and feeling the pressure to care for larger numbers of patients, especially in uncertain economic times, he adds.

For people who have been accustomed to taking care of others, resentment to being of service is often accompanied by shame and guilt, says Dr. Eagan. The good news is, small changes—such as cutting back on your workload or taking a break—can often bring back the spark. “Even stepping away for a couple of long weekends in a row can help you see the passion reignite,” he says.

Living Under Pressure

For healthcare providers, personal challenges can also spill over into their professional lives. “Problems with a spouse or children, or financial or health concerns can affect our attitude and bedside manner,” says Anahid Derbabian, MA, a nationally certified counselor in private practice in Bloomfield Hills, Mich. “How can we give a sense of hope when we don’t have it ourselves? If a chiropractor is feeling overwhelmed, how well will he or she treat patients and give them options? It is essential to honor and manage personal, health or career challenges separately,” she adds.

The problem is, doctors often feel that they can’t reveal their personal problems or negative feelings, says Randy Kamen-Gredinger, EdD, a psychologist who has been working in the areas of resilience, stress and pain management for more than 30 years. “Everyone holds doctors on a pedestal. They are supposed to be role models—authoritative leaders who have all the answers—and many buy into it, putting themselves under the pressure to find answers that may be impossible to find,” she explains. “The pressure to perform at a very high level all the time” pushes many to abuse alcohol and drugs and resort to other unhealthy ways of copying.

Perpetuating the cycle is often the fear of “compromising their standing in society” by asking for support, as well as “sophisticated defense mechanisms that many healthcare professionals develop,” says Rick Singer, MClinPsyc, a psychotherapist who currently teaches at the International College for the Cayman Islands and who has treated physicians in the past. “Doctors tend to rationalize their feelings and behavior, instead of seeing them as abnormal and seeking help.” For example, he says, healthcare providers may say to themselves that depression is normal for someone who is as busy as they are—or that they need alcohol or drugs as an outlet for their stress.

Feeling Stuck

Even without apparent professional or personal challenges, people can sometimes find themselves “going through the motions,” says Derbabian. “You may be in a successful practice, and your financial situation is stable, but have you created a fulfilling life for yourself?” she says.

Dissatisfaction with close relationships may be one sign of an imbalanced life. “Ask yourself, ‘Do I have strong and positive relationships with people who I care about, trust, who feed me and who I feed emotionally and socially?’” advises Derbabian. Feeling that you are “racing through life” may be another red flag. “Are you experiencing the journey—or are you always trying to arrive at a destination and check it off the list?”

It’s also helpful to ask yourself if your life is consistent with how you envisioned it, she says. “Celebrate the positive things and tend to the ones that are not working. Are there specific actions you can take, new decisions you need to make, or conversations you can have?”

Self-Assessment

Looking for unresolved issues should start with monitoring the current situation, says Alan Allard, MS, a psychotherapist, stress expert and author of Cracking the Stress Code Six Strategies for Thriving Under Pressure and Uncertainty. “Ask yourself, for example, ‘On a scale of 1 to 10, how good do I feel about how my day has gone?’ Or ‘Has anything happened today that has created stress that I need to be aware of?’ Or ‘Is there anyone around me who is unhappy, frustrated or impatient with me for some reason?’” Allard notes that the last question is especially important because “stresses and challenges will always show in a relationship—with a staff person, family member or patient.”

Dealing with issues may involve setting boundaries, he continues. “If someone has a reasonable complaint, resolve it to the best of your ability. If you find that the complaint is unreasonable, you can still do your best to resolve it, but you may want to explain what you can and cannot do—and then explain the boundaries you set for them.” After resolving the issue to your satisfaction, it’s time to move on—even though the other person may not be completely satisfied, he says.

Sometimes, though, the problem may be ongoing. For example, a spouse, colleague or friend may point out that your relationship is becoming a problem because you are working too many hours and not getting home to see your children, or suspect that you suffer from psychosomatic illness or stress, says Fierstein.

To put things in perspective, ask yourself, “Am I feeling physically and emotionally in control of my life right now? Am I feeling different than I usually am?” says Joshua C. Klapow, PhD, a clinical health psychologist and associate professor at the School of Public Health, University of Alabama at Birmingham (www.drjoshk.com). Experiencing difficulty sleeping and regulating emotions, as well as some physical symptoms—fatigue, headaches, stomachaches, skin problems or lack of energy—may point to issues that require professional help, he says.

“If your ability to function is becoming impaired, get help,” Dr. Klapow continues. “Just as you, as a chiropractor, have a confidential relationship with patients, the job of mental health professionals is to protect our relationship with patients. Confidentially is in our ethics and legal standards—we treat high-profile patients almost every day.” Explain before the appointment who you are, the nature of your profession, and discuss any concerns you have about confidentiality and anonymity with the provider, he suggests.

Before unresolved issues escalate, “it’s much better to seek the help when your colleague or family member points something out,” says Singer, who has treated healthcare providers with addictions referred to him through a mandatory state physician referral program because their colleagues reported their problems. While the program helps physicians recover and get back to practice, it stays on the patient’s record, he says.

Seeking Support

Instead of isolating yourself—which people tend to do when they are feeling unhappy, dissatisfied or going through difficult times—reconnect with people who are “supporting, loving, and who want to see you happy and fulfilled,” Derbabian says.

Those dealing with divorce or grief should “seek out counseling or have a social support group of positive friends and family who can be there to listen, non-judgmentally, without injecting their own opinions and views,” says Fierstein. “If you don’t ask for help, grief can become a real problem, leading to sustained anger, anxiety, fatigue and helplessness, and you can end up infecting the people you are trying to help.”

In addition, remember that a life change is a process. “Telling yourself, ‘I should be over this by now’ will only compound the problem. Get feedback from someone you trust, someone who can say, ‘You are really doing pretty well, but you need to be patient,’”Allard says. Self-care is also key. “Discover what will help you in the healing process, such as getting professional assistance, journaling, exercise and nutrition, or attending to your social needs,” he says.

Tags: adjustment, Press

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