Hello podcast fans. It's time for another episode of Therapy Natters. Where myself Richard Nicholls and fellow psychotherapist Fiona Biddle, we sit for 30 minutes and will natter about something that we think might be relevant, usually in response to questions submitted by you. Good day, Fiona. Here we go again.
Yes, Episode 35 already. And yes, I, I don't understand how that has happened, but life is a bit like that, isn't it? Complicated and busy and
it is. I've, I've got many hats. I've got, obviously I'm a psychotherapist and that, I think when somebody says, you know, Who are you? What do you do? I'm not sure, I think the psychotherapist is probably the first thing that pops into my mind, but it's, it's followed up very quickly with I'm a psychotherapist with a podcast. I produce mental health content. I almost seem to identify more as a podcaster than as a therapist these last five to 10 years. But of course there's more to me than that.
I also help run, an amateur dramatic society. That's a big part of who I am. That's another hat that I wear. And what else am I doing? Well, I'm a, I'm a husband. I'm a Dad. That's, that's a couple of big hats. And I'm a friend that's another hat. Oh, if you're not careful that's too many hats. Eventually your head gets heavy and fall over if you ain't careful.
To think of all the roles that we each inhabit and how they change over time. I mean, you said you're a dad. Well, your son's just 18, isn't he? But, And I'm a mum. But, my sons are older 28 and 30, So you'd think that they wouldn't need me so much, but there are occasions when they don't act like that age. But , that's, that's probably a good thing. The roles do change and so my role as daughter has changed now that my father's needing me more. It's all good. It's all fine.
Part of life's rich tapestry. But yeah, the roles change, don't they?
Mm. And as long as we are all okay with that, that's fine. if our identity's, I think too much in one place, we put all of our value, all of ourself into that. If that is in some way fractured for some reason, then it makes us feel like we might be fractured. And we see a lot of that in things like nurses, teachers, and therapists.
If that's what we identify ourself as, if we're struggling in that because we're busy stressed, then we begin to lose who we are outside of that role when we are doing other things, cuz it creates this feeling that we are broken in some way.
There's also an element within that of how self-determined a person is within the role. How much it is imposed by the outside world or the place in which one inhabits that role. So I think a lot of teachers, if they were just able to teach, wouldn't feel so much pressure that they very often do because of the imposed pressure to do other things and to do their teaching in a particular way.
Yes, cuz they're getting their rewards met. They're in a rewarding position, and I don't necessarily mean a financial reward. Our job can have obviously financial rewards, but what we do know is that that's not enough, that we need more than that. Because if we have no other rewards other than financial, then there's something out of balance in the equation. Which means we get more stressed We don't enjoy our job enough cuz it isn't rewarding.
You were saying something earlier on that our clients have been talking about anxiety for years. It's probably the most common reason people seek therapy, but you've noticed it too over the last couple of months. the word anxiety has been replaced with the word stressed. People are feeling more stressed over stuff, not just anxious, actually stressed cause it's situational.
you say about anxiety being the word for the last 20 years or so. If I go back to when I first started as a therapist, stress was the word and anxiety wasn't. And gradually that changed. And I can remember because I was thinking, I know how to work with stress and I understand that. How do I work with this anxiety thing? But you know, you learn as you go along. And yeah, then it's just lately, just I say over the last few months people are starting to say they're stressed again.
It might be difficult to separate the two, but to me stress comes with, thoughts. Often the thoughts come first there's an emotional response within the body. Anxiety's when that's become so ingrained, so habitual that it's just there. The thoughts come after the feelings. The feelings are there first, which follows on with the thoughts of why am I feeling so, so sick about this? Oh it's probably, cuz everything's gonna go wrong, isn't it? It's that way around.
Whereas stress to me seems to be, the thoughts are This world is falling apart. This is horrible. Which leads then to stressful feelings within the body. That's how I think of it.
I see it slightly differently, although I don't think these things matter at all. But I see it that stress is about now. I feel stressed now because now I have to do this, this, this, and this before that time, and this person's relying on me to do it and I can't do it because of that pressure, that stressor. Those sorts of things. Whereas anxiety is about the future.
Now, that future might be later today, or it might be the rest of one's life , but there's always some sort of future element to anxiety.
That makes sense.
So I suppose then , the, logic taken from that is that the current present day troubles have significantly increased for an awful lot of people over the last few months. Well, maybe you take it back a bit, go back to full pandemic time, but people weren't saying they were stressed then they were anxious then, but most of the anxiety that I was seeing then was health anxiety. And existential anxiety, which we've talked about before. Cause it brought it to the fore.
People were worried about their own health, worried about the health of other people, worried about dying, worried about other people dying. And worried about sort of how am I going to get through this time? So it was more future based I guess,
Yeah. And of course the sort of frustrations being, being locked in and not having enough control. Ah, control, yes, that plays quite a, quite a part in it, that if something's outside of your control, you don't have a choice, then it is gonna tighten us up. It is gonna make us feel stressed, frustrated. Maybe angry to a degree, but it is. Yeah, Control plays a part. I remember Oh, what was the guy's name? I wrote him down. He, Oh yeah. Herbert Freudenberger.
You ever heard of Herbert Freudenberger, Fiona.
No, but what a fabulous name.
I know. This was in 1974. He came up with the word burnout. It was him that phrased that. Which he defined as The extinction of motivation or incentive, especially when one's devotion to a cause or relationship fails to produce the desired results. A bit wordy, but hey, Herbert. Gotta start somewhere. And he called it burnout. I think it was more for, it was about teachers and nurses at the time, but anything to do with the caring profession.
And I mention this because we've had a, a couple of messages over the last couple of three weeks that we've, we've stuck together. Cause we tend to group our questions together, don't we? That revolve around this. Let me dig 'em out. Shall I read one? I'll read.
Yes. Cause we changed our communication system. So I dunno quite where they are now.
Yeah. WhatsApp it to you? Yeah, yeah, yeah. I'll read 'em both then. Okay. So first of all, we've got Patron Lizzie from Patronshire. I suspect that might not be her genuine location. Possibly not even a real name for all I know. So, Patron, Lizzie so called says. Hi there, Richard and Fiona loving the podcast. Thank you so much for making them. I'm a counselor in private practice for over 10 years and would love to hear your tips on how to prevent burnout. On occasion.
I found myself losing empathy and needing fewer clients to exhaust me. Exhaust. I don't like that. Yeah, when I notice this is happening, I tend to withdraw from social events and get some early nights, which helps. But I would appreciate your advice if you have any. Thanks again for the show, Lizzie. And also we've got listener Gavin. Gavin asks, Is it wrong to have emotional fatigue? And emotional fatigue is often another word for burnout, or at least would be a symptom of, of burning out.
Yeah, it's, it's interesting to have those two questions phrased rather differently, but going back to the comments you were just making about control, Lizzie's in private practice, so she, presumably, is in control. There's nobody telling her what she should do. Although that does make me think I know of a couple of people who find it really hard to say No to any new clients, and so their diaries get too full or they don't, say, Oh, no, I don't work evenings, or, No, I can't
00 AM on Saturday, or
probably me at one point in my early days.
Well, yes. I mean, it's, it's, it is difficult to, when in private practice, well, any self-employed person to say no to any business because you sort of need it. So it's a, it's a tricky one. And there's certainly the pushing of time boundaries is one that many of us have had to work through. so she's, she's got some control, but then maybe that can be, that can be looked at.
But the bit of control that I'm thinking that she could really activate And I'm not saying you're not doing this Lizzy, but just very, very specifically boundary, mentally each session so that you are just with that client. This might sound odd to any client's listening, but just be with that client for that hour To then leave them there if you like and don't take them with you. I just rather suspect from things I've heard people say before, we've all done it to a degree.
Sometimes our clients can bleed over into our normal lives. So we might be wake up at three in the morning and think, Oh, I wonder how that person's doing. And a lot of our clients do have very sad stories and very tough lives, and that can be, not a good thing.
No, it is, it is difficult and I think for, for new therapists, I know Lizzie says she's been a therapist for 10 years. New therapists, particularly, will find that quite hard cuz they are, they don't have the practice of being able to have those boundaries in that says, Well, that client's walked out of the door now and the next one has come in and they're two different people and I've got to be there 100% present for this client. When they might still be carrying the previous one over.
People outside of the profession say, Oh, how do you, how do you handle that? When clients bring sad stories to you? You just get good at it. You feel it in the sessions. I've got a separate packet of tissues for me and, and there's another one for the clients. I'm gonna feel with them when they're there, but when they walk out, I can't. I don't bury that empathy.
I don't bury all that feeling that I had, but with practice, you learn they are taking their feelings with them, or rather, no, that's a lie. they're taking my feelings with them. That's how it is. They're taking my feelings with them. They can go out of the door with them what I used to do, I remember doing this in my early days. If I shook their hand as they left the session in my mind I'm taking the responsibility for them and those feelings that I was having out there. There you go.
You can have your crap back as I shook their hand. Take care. See you next week. Have that. And they're gone. And I can take a few deep breaths and make a few notes in my diary, Check my emails, pour myself a glass of water. And sit and wait for the next client to come in five minutes later. I don't do that anymore. I don't seem to be needing to shake their hand anymore.
Because it's automatic. You set up that process for your mind to have that boundary to, make that difference. I've known people to do all sorts of little rituals. Um, Some people will do a grounding exercise, for example. They might literally touch the ground with their hands to leave it. But going back to you are giving them their stuff back.
Yeah. Bless you.
Giving them their stuff back, but also they're leaving it here. They're leaving it with you.
Oh, yeah, yeah, yeah. To them.
It's a funny thing because both are happening at the same time. So they leave it behind you send it with them because it's all about the, the internal processing of each individual. So, that's fine. But what this then reminds me of is something that we've talked about a couple of times on here in episodes 18 and 25, but we didn't get into this particular aspect that I want to go into now, which is, Well, the theory is about compartmentalization. I do like saying that word.
Hmm. Good word. Bouncy word.
Nice word. As, as we've said before, that's about doing the thing that's right at the right time. So if you're working, work. If you are resting, rest. If you're playing, play. We had a, I think it was 25, was called work, rest, and play.
Oh.
This extra bit to bring into it is about the the energy that whatever that task is that you're engaging in. What the energy is like, and you can have positive and negative energies to things, and that can be either mental or physical, and it can be high or low. So you can have any combination of those three things, which if you think of it as a three dimensional cube divided into two, on each axis.
You get eight little mini cubes for each combination of positive and negative, high and low physical and mental. So, If somebody was, let's say working on creating a spreadsheet, let's just think that they've been given a task at work. You need to create this spreadsheet. And it's complicated stuff, complicated data that they're putting into with equations going backwards and forwards and all the rest of it.
But it's a good thing that they're being asked to do this and it's got a good reason for it. Therefore, it's a positive task that they're doing. And it will be high energy, but high mental, positive energy. So then if we look at the physical side of that, it would be really good to be in low positive physical energy.
Yeah.
And a lot of the time people are doing those sorts of activities. They're not. They're sitting on the edge of the chair with their feet tapping and just stressed, physically stressed and worked up. So to sit in a comfortable chair whilst doing it make sure you're physically comfortable. Et Cetera, then that makes the high mental positive that much better. So let's give an example of something where there's a high positive physical. That might be somebody who cycles to work, for example.
That's gonna be a positive cuz it's a good thing to be doing. Might not feel like it if it's raining, but still it's positive, high physical. Use that time to relax mentally. So it could be a positive mental high because you're just chilling. It's quite um, hypnotic, isn't it? Cycling with the rhythmic process. Just pay attention to what's going on. But look at the scenery.
Look at the, If you're in, in London, look at the people, look at the buildings, but obviously pay attention to the road first. Examples of the negative. If you've got a toothache for example, that would be a negative high physical, cuz of the pain. And if you're feeling down, then it might be a negative low mental But that could be the right place to be. If something sad is happening in your life, then that's an okay place to be.
So I guess the basic premise of this whole idea is to think about the situations that are causing stress and to maximize to get to be in the right cube and also get to be in the right cube at the times when you're doing things that aren't the cause of the stress. So if you go on holiday which presumably is designed to relieve any stress or burnout, that's sort of what holidays are for, then make sure that you are in the right cubes, right mini cubes for those things.
A lot of people take their stress with them when they go on holiday. They spend all year desperately looking forward to go on holiday so they can leave their work at home, and they take it with them in their head. And that's what they're thinking about all the stressful things they've gotta deal with when they get back.
Or they do their emails, or they do sessions when they're away, which is what I do,
Eh
Not, not clients. I don't do client sessions when I'm on holiday. I might do supervision sessions when I'm on holiday. Different thing.
It's still work. Fiona
That's not, is not a stress. They're more often a, source of positivity. But yeah, sometimes it can be
Hm.
So what else can we do?
One of the important things to do is to look at the things that you DO have control over. To look at maybe your health, how much water you drink, the types of food that you have, the amount of salt that's in your diet. Those things are in your control to a fair degree. And if we are giving our body more stress, if we are having late nights and we are saying Yes to every social event thinking, I just, need to have some fun because everything else is so difficult.
We might associate nights out with friends and so on with fun. I know I do, but if you do it too much, you're not gonna be getting enough sleep. And it might be that sleep is more important than catching up with friends. Not always, cuz sometimes there's the benefits, the social benefits of the social stuff. But, look after you. Listen to your body. Cause I think our emotions are called feelings for a reason. We feel them in our body.
And like Gavin says, he asks the question, Is it, is it wrong to have emotional fatigue? No. It's human. It's part of being human. It isn't nice, but it's not wrong. It's not dangerous. It doesn't mean that there's something wrong with you. Maybe that's what he's asking. Maybe he's thinking, Do I need to go see my GP over this because I've ran out of emotions. I don't care anymore. I just don't care. And I dunno much about Gavin. I dunno what he does.
Whether he's a therapist or is in a caring profession, potentially maybe. It certainly sounds like he might be dealing with people.
but not even necessarily that. I mean, we hear the term compassion fatigue. That takes me back to when we talked about defense mechanisms. If we don't limit how much we take on of other people's pain and suffering. It's too much. And then we will get compassion fatigue. And there's so many, so much on tv, every news broadcast. And adverts for please donate this to this charity and that charity and if you listen to it all, well you're gonna have compassion fatigue cuz it's just too much.
So I suspect there's something there with Gavin that he's either in a situation where, There's an awful lot being thrown at him or he's allowing himself to see more than is healthy for him.
Mm.
That might sound harsh, but we, we can't take it all on. We can't solve all the world's problems.
No. And there's a lot of them. There really is. And like you say, we're being exposed to it. Good news doesn't sell. It should. And I know I've got a lot, I've got some tabs open on my Safari browser here. What's that one? happynews.com and there's huffpost.com. There's a good news section. What's that one? Another one positive.news. So does that mean that we just have to turn off the telly? Well, yes and no. I think maybe avoid some of the news.
And I know that's difficult cause we get drawn to it, don't we? But there are good things to, to enjoy about, television, even if you have to watch repeats. I gave homework to somebody the other week of watching Brooklyn Nine. Nine,
I gave homework to somebody the other day to watch Sky Nature.
Just the job. Perfect. Yes. To a degree, anything with David Attenborough. I mean, some of it can be a bit, Oh no, that Mongoose's gonna get it, but
I expected this person to say Yes, But. Because this client does tend to say Yes, But
Ah
I, I was expecting a yes, but you see tigers killing zebras. No, that's not right. Lions killing zebras. If you saw a tiger killing his zebra, that would be quite fun.
Be at the zoo, it wouldn't be fun.
Well, you know what I mean? It'd be unusual, let's say unusual, not fun. But I, I didn't get that response. Now the client hasn't come back for the next session yet, so we'll see. I suspect it'll still be a Yes, But I didn't know what number it was or some such thing, but I did, I did say, First of all, do you have, And yes.
and you are helping them to see that they do have control over their life.
Yeah,
That they can steer it in a particular way that gives them what they need.
Thinking of the control. Most people in the uk would have access to the iPlayer. Not everybody, but they could watch the news on the iPlayer and get the gist of a story, and then fast forward through all the nasty bits. And the, the people on the street saying how dreadful whatever it was, was, so they get the key bits that they feel that they need to know, but not, not sort of soak in it. So there's a lot here about balance, isn't there?
There's a lot about taking control of what you can control, controlling the controllables. And yeah. Getting yourself into the best place you can for whatever it is that you're doing.
Yes. And Lizzie says what they find is they withdraw from social events and get some early nights, which helps. That's gonna help her.
And being physically active. Keeping the body going, keeping the body moving has so many benefits. And people tend to think, oh, You know, exercise. Well, a lot of people, women especially will, will tell, Oh God, I don't like exercise, walking swimming just being physically active a little bit more than you were before. Using the stairs rather than lifts. Simple things of keeping the body going are not only good for the body, they're good for the mind as well.
In fact some GPs prescribe exercise for mental health issues.
Yeah. And, and they should. We do know that when you move, when you, When your heart is pounding. When you're getting a bit warmer, which you know, we could all do with jumping up and down on the spot lately, couldn't we? Especially today. It's flipping freezing. the brain says, Oh, I am in a good position. Maybe it harks back to being, being able to run away from lions and tigers. And if our brain knows, Oh yeah, I know how to move. It gives us that, Oh, that means I'm gonna be safe.
Sort of feeling. So many clients that have come to me in the past for motivation to exercise. You have to look underneath and go, Okay, well why weren't you doing it before? What was going on? And sometimes it can be as simple as, I just don't like being sweaty , Well, okay, you've gotta learn to like it or you've gotta learn to tolerate it. You've gotta learn to break the association with being hot and sweaty being a bad thing.
Then you put it into place, you compartmentalize and go, Well that's when I have a shower, cuz that's when I'm gonna get sweaty.
I think there's a, I said about women an awful lot of well certainly women of my age, it goes back to school. And that you, Well, we didn't, I was thinking about this just the other day. We didn't have showers at school. So after PE you just changed back into your ordinary clothes.
Oh No,
And
I think that that does still happen at times.
but the, that just didn't exist. But also this, the sort of cultural thing that teenage girls don't want to be looking a mess.
Men Sweat and Women Perspire
no, no, no, You got it wrong. Pigs, sweat and men perspire. But women merely glow.
Oh God. That's even worse. Oh. How judgemental and,
mean, well, yes. Well, I dunno, It's sort of could be seen the other way around as being, It's quite nice to say that the woman, there's nothing wrong with what happens to a woman. You're just glowing.
Mm. Except she doesn't feel like she's glowing. She feels like she's sweating. No. Okay. Yeah.
I dunno who wrote it or what the intention was, but there's there's a lot of cultural, stuff around exercise and also, I mean, I, I dunno about you, but school PE for me and, you know, my ex-husband, this was his, well, is his subject, so, I know a lot about the research that backs this up. I'm not, not just speaking anecdotally that the things that we were made to do in in PE like hockey on a cold winter's rainy day. And there are some people who like that, but most people don't.
And there weren't very many options of things to do that people you know, who aren't sporty, sporty people would enjoy. We didn't get to play tennis, for example. I mean, I liked tennis when I started playing that. I like trampolining. I did trampolining an awful lot, but that's inside and in the warm, that's good. Like being inside and in the warm. Uh, So there's, there's a lot that it turns people away from being physically active when that's not necessary.
the same for many things. If we've got these associations, even like the early nights, some people might associate an early night with being old and boring, and I don't wanna be old and boring. I wanna be youthful and bouncy and fun and alive That might have been me at one point when I was 21. Now I'm 46. I'm. Actually, I did this last night. I was invited to go and watch Singing in the Rain last night.
And I was fully expecting to go, but I had a full day of clients yesterday and I was tired and I didn't get home until quite late. And it would've meant not really eating much if any of an evening meal other than just grabbing something from McDonald's on the way to town. And so I had to apologize and say, guys, and I said these words, I need to practice what I preach. Need a bit of self-care, feeling tired. See you next week. Not gonna be able to make it tonight.
And I think that's probably the first time I've, done that and not felt guilty. I've done it before, but this time I didn't feel guilty.
Oh, well done
Didn't feel like I let them down. Yeah. Woo-hoo. I win sorry everybody. I know they, would be listening to this, especially Colin. Sorry Colin, it was you that invited me.
I'm sure Colin's going Woohoo as well. They sort a great little meme on instagram or wherever. Yesterday saying this guy was saying he'd been tricked all during his childhood when he was told he had to go to bed at nine o'clock and he was, Oh, I can't wait until I'm a grownup and I can go to bed whenever I like. And now I've discovered that's nine o'clock
Yeah. That'll come to us all. I'm sure. I, I've not gone to bed at nine o'clock for a very long time if I've been well
Oh, I, I often do, but I read for ages.
Mm
So it's moving from you know, being in front of the telly and embroidering or whatever crafty thing to going to bed to read. So it's all good. It's all fine.
So I think what, what we're saying here is we all need some self care in order to get through the difficult times that we're experiencing.
So pay attention.
Yeah. Being aware, of what's going on. Pay attention to your body, listen to it. And if it says, you know, I have no compassion anymore, I have no empathy, I've run out, nip it in the bud. Don't wait until it completely runs out. Cuz yeah, if you're a therapist, that's, that's gonna make life really, really hard for you. Listen to it beforehand and go, Oh, this feels like I can't go and watch Singing in the Rain tonight after all. Might mean I need an early night.
Hmm. Just listen to what's going on and that's why I think we do need time to think and feel for ourselves. So often we just go from one thing to another. We come home from work straight into something else, might be making the evening meal, and then we sit in front of the telly and watch something. That finishes we tidy it away, we come back in. What else is on the telly, for example? I mean, that is a common story that people will tell me. They don't sit and just think.
My wife Dawn, she's classic introvert, so she will, she, she doesn't need the telly on, she'll just sit. And she might be doing something with her nails or she's just scrolling through the internet, but she's not doom scrolling through horrible stuff on Instagram. She's looking at videos of what was she showing me yesterday. Cause that's exactly what she was doing. There was a cat, there was a dog, and there was just some funny little nice videos Oh, oh.
And a turtle that was upended and was flapping about and couldn't get up. And so all of these turtles all swam over to it and tipped it up. And she went, Oh look, they helped it. They helped it. I was like, Yeah. All creatures are pretty good, deep down, probably even sharks and crocodiles, if you really got to know them, especially sharks. They got a bad rap. Yeah, they're all right. Really. You know, sometimes you do just need to chill and not be stimulated. Listen to what's going on for you.
I think that should be everybody's homework every week, shouldn't it?
Yeah, absolutely. We need to finish up.
We do. So I want everybody to go and do that. Spend some time getting to know themselves so they can hear what's going on. If they need to chill, chill. If they need some help with that, we have a YouTube channel full of hypnotherapy recordings. Have a listen. Link is in the show notes. Go and chill out. Spend half an hour every now and again, just chilling. Make that part of your routine. It can only do you good.
And just to say our recordings are mostly about using hypnosis as you go to sleep, and so it doesn't actually take any time out of your day.
Yeah. I mean, you were gonna rest at that time of night anyway,
You get the benefit and don't lose any time. Win-win.
Aha. No excuse Right then keep your questions coming everybody. As always, link us in the show notes to the form to fill in, send us some questions, some topic ideas. And believe me, we can soon put something together, we can answer your questions and natter away for what seems like longer than we should have done cause we need to edit this one down quite considerably. Have a super week, everybody. Take
Okay. Bye.