Burnout, Attachment, And The Helper’s Heart

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Chapters

• 0:00 Opening And Personal Context
• 2:45 Childhood Trauma And ACE Score
• 5:10 Adaptation As A Superpower And Risk
• 8:40 The Incident That Triggered Leave
• 12:05 Attachment Patterns At Work
• 16:20 Praise, Overfunctioning, And The Cost
• 20:55 Naming Burnout As Erosion
• 25:00 Value, Faith, And Inherent Worth
• 29:00 Culture Change And Asking For Support

Transcript

Opening And Personal Context

SPEAKER_00 0:06

Hey everybody, and welcome back to the Wednesdays with Watson podcast. My name is Dr. Amy Watson, aka the trauma doc, and I am your host. We are coming up on almost six years for this podcast. That's really hard to believe. The last three years, though, I have finished up my education to receive my doctorate degree in trauma and community care. And so today I want to talk to you about something deeply personal. We are going to talk about childhood abuse, attachment styles, and burnout for people like myself who work in positions, professions that help other people. Because as I am recording this in February of 2026, I am on a doctor mandated leave of absence from my work. I tell people all the time that the serial killers didn't have to stop my heart to take my life. And if you don't know what I mean, that is part of my story, my sister and I both babysat by well known serial killers. They did not stop my heart, but sometimes I feel like some of the things that they did and everything that happened after them stands to take my life. I've been frustrated over the last week. It's been one week since my doctor put me on leave, and I've been frustrated. I have spoken to myself in ways that I would not speak to you or anybody else who is experiencing what I am right now. Lots of should you should be able to, you should be able to, you should have, why didn't you language coming in to my aura. And I think that it's important to normalize that. And today we're going to talk about why people with a history of trauma, particularly childhood trauma, have to be extra careful when working in professions that help others. And so as I mentioned, today's episode is deeply personal for me. So let's just drop into this episode where we talk about childhood abuse, attachment, and burnout for those working and helping professions. As I mentioned, today's episode is deeply personal for me. Not in a dramatic way, but in a grounded and an honest way. I want to talk about childhood abuse, attachment styles, and burnout for those of us who work in helping positions. And I want to be clear from the start, I am not talking about this from some academic way. This is something that I experience as I work in a helping profession, working with patients who need crisis stabilization at the darkest times in their lives. And every day when I walk into that hospital, there's something that happens inside my spirit. When I first started working there, I would say, I can't believe that I get to do this because there's something about being in the helping profession when you've been through some things that makes everything feel maybe less icky. But I walked into these jobs, this job, with an adverse childhood experience score of nine out of ten. That is about as bad as it gets. The only thing that I did not have or experience on the adverse childhood experiences list is somebody being in jail. And if you want to go look at the adverse childhood experiences, you also can take that quiz. It might be helpful as you process this episode. Just Google adverse childhood experiences and we'll put it in the show notes. I don't share that I have an A-score of nine for shock or sympathy. I share it because it matters, because it does shape how I understand this work of helping people. It helps shape how I entered it, why I entered it, and it helps us understand why I am now clinically burned out. As I mentioned, if you're unfamiliar with the adverse childhood experiences, this measures exposure to abuse, neglect, and household dysfunction. A score of nine means that my childhood was not organized around safety. It was more about adaption. And that matters, right? Because adaption for a job like mine, where you're walking into things that can be unpredictable, adaption is exactly what many helping professionals professionals need. And so I was perfect for it before a single thing that I learned, educational-wise or professionally wise, for that job, the fact that I could adapt because my whole life was built about adaptation. Oh, this is unsafe, let's go here. Oh, this is unsafe, let's do that. And children, I got very used to adapting to chaotic, crazy environments. And I just described what it's like to work on an inpatient psychiatric unit. Unpredictable. Part of what sent me into this tailspin, as I should not call it, is I saw one patient attacked another patient completely unprovoked. And I was about 20 feet from them. And all I could think is that would be me. That could have been me. And I didn't really have a good adaption to that. I just kept walking out the door, which is not what you're supposed to do if you're in a helping profession. You're supposed to run towards it. But that is what set me off. And so my ability to not seek safety, but to adapt and what is given to me makes me perfect for this job. I did not choose this work because it was unfamiliar. I chose it because I already knew how to survive inside intense environments. Like many helpers, because of my childhood, I learned early how to read emotional shifts. I learned how to anticipate needs, and because of my personality, when I see a need, somebody taught me a long time ago, errantly, I might add, that a need seen is an assignment given. I learned how to stay regulated while others weren't. I'm not great at that, but a lot of uh adult survivors of childhood abuse are flat affect is what we call it. I'm not able to stay regulated when others aren't, and probably part of leading to burnout. I took responsibility far too young. I don't ever remember not being an adult, not making adult decisions, not having to work for my food. Those skills that once kept me safe later became my resume and why I am good at working in a helping profession. But for a long time, all of this just looked like resilience. When we think about attachment theory and how that influenced not only my choice of being in a helping profession, but how I operate inside with coworkers and patients. So when early relationships include abuse or unpredictability like mine did, attachment isn't about comfort, it's about maintaining connection, right? And so now you put somebody like me on an inpatient psychiatric unit who wants to maintain connection with people, right? And so you learn to overfunction, be useful, stay alert, minimize your own needs. One of my friends who was a doctor at the hospital when I first got there said, Amy, you got to remember this is a leaky faucet, not a fire hose. But yet I could not take that advice, and everything seemed like a fire hose. And so I when I'm at work, I am zero to 200. And so I overfunction. I want to be useful. I have to stay alert, right? And there's alarms going off and all kinds of things going on. But because of those early attachment issues, I learn to earn the care and love for others by overfunctioning, by being useful, by minimizing my own needs to help others. Well, that turns into a good adult in the work world, right? Because then I step into the helping profession and suddenly these are the patterns that are praised. These are the patterns that get me team member of the month, these are the patterns that won me a scholarship award because they see me as dependable. They see me as somebody that goes above and beyond for the patients. And right before I went on leave, I had a sit-down with some people who said who were just pointing out some things that needed to be pointed out, and they identified how above and beyond I go for patients. But no one really asked about us, right? If you're on a helping in a helping profession, really everybody's there trying to survive. But the question is, what did it cost me to go above and beyond? Because I learned those in childhood, right? I learned uh that I didn't get abused by my stepdad when I brought home an A on my report card. Being dependable, being useful when I got teacher notes uh talking about how helpful I was, how I'm always looking out for other people's needs. These are things talking about me in childhood that made me perfect for a healthy profession. But the body keeps the score, as we've talked about so many times on this podcast. No one has officially used the word burnout for me right now, but burnout in this context isn't about my inability to do my job. It isn't about whether I'm weak or whether I lack skill. It is about this idea because I did not learn to attach in childhood. I learned that attachments meant that I needed to do something. And so burnout often happens in these situations and helping situations with relational overextension. Because helpers with trauma histories, burnout doesn't arrive as failure, it arrives as erosion. For me, it looks like right now deep exhaustion, a quiet persistence of I can't keep doing this, growing resentment, honestly, towards systems that ask for more without offering protection. That and when that situation happened at work, a lot of people just casually said, Well, that's just psych. And that did something deep inside of me that made me feel like I didn't matter. And so every day I was sitting in my car, staring off into space, dreading going in, not able to eat, not able to drink, not able to participate in normal life, because even as I speak to you today, and I've been off from work for a week, I'm exhausted. There's not enough sleep. There's just not enough of any of the things. So when you have a high adverse childhood experience score, and this is the warning to those of you listening, burnout will come for you. But when it does, and if it does, if you don't learn to take care of yourself, and podcasts after this are going to be with Lauren Starns, how we can live with adverse childhood experiences, how we can work in a helping profession, and how we can maybe not burn out by learning that it is not a relational failure when you can't do something at work. It's not like you didn't try hard enough, it's not like you should have tolerated more. It's not like your needing rest is a flaw in your character. That's the attachment issues talking to you. And so if you are under the sound of my voice and you are feeling burned out because you're in a helping profession and you have a history of child abuse, particularly attachment, you're going to make your job, you're going to make everything about earning the love and the acceptance of other people. And guys, I'm here to tell you, because I'm experiencing it right now, that that only lands you flat on your face. Because you see, we talk about value all the time on this podcast. When I first started the podcast, one of the taglines was, you matter. And sometimes I have to remember that I matter too. And that when I'm in what I feel like is my calling, I've been walking around saying I don't understand why God would make me so good at something and why he would make me love something so much, and yet I'm not built for it. And when I began to study to write this podcast, I understood that I have to go back and I have to deal with some of those adverse childhood experience things. And I have to, I have to get it deeply beat inside my psyche that my value is not connected to whether I help people, that I will continue to burn myself out, and so will you if all you want to do is people please. And a lot of kids that have childhood abuse, attachment disorders are going to have these attachment issues, you're going to have abandonment issues, you're going to work yourself in the ground because that is how you find your value. But I am here to tell you, and I'm here to preach this to myself, that my value is found in the fact that I was made in the image of God. We see that in Genesis 1.26. It doesn't matter if I ever did another thing, I have inherent value on this planet and inherent value to God, and so do you. When we understand that God loves us so much that all we do is open our eyes and breathe, and we are already his favorite. I think of the passage in Luke chapter 3, where John the Baptist is baptizing Jesus, and uh as soon as the baptism is over, the Father says, This is my son and whom I am well pleased. Do you know that the God the Father said that about Jesus before he said, before Jesus had accomplished anything? He had not done one miracle, and God was pleased with him. And so I know that many of the people that I work with may listen to this podcast, and I'm speaking to you. Guys, we can change the culture if you work in a helping profession. And if you're not burning out because you're not dealing, you're not waking up with all this trauma, the history of trauma, particularly attachment trauma, if you are in a helping profession without a history of these things, you're not going to have as high of a propensity to burn out because you're not looking to attach to people connected with your value. Help us. Help us recognize that we matter too. And that going over and above and then above and above and above and above that doesn't do anything necessarily more than if we were able to just make it good enough for the patients while saving some of our own emotional energy. Let's talk about prevention. If those of us that want to stay in this profession, we got to pay attention. And Lauren's going to tell us a lot about that. So let's talk about prevention because trauma-aware prevention looks different. If you have trauma, this is something like brushing your teeth, your hair, getting dressed every day. If you work in a helping position profession, you gotta pay attention. And this is what I didn't do. And I know better. I am the trauma dog, and I didn't do this. Okay. So for me and many helpers with trauma histories, prevention has meant this: paying attention to resentment, not just fatigue. Now, that resentment is a hard word, but I did find myself resenting because when you work in this position, one out of every hundred people probably are grateful for you, probably say thank you. And so you begin to resent pouring out so much with nothing in return. And that leads to burnout. You ask yourself when you walk into this, am I choosing this? Am I choosing to act like this? Or am I just reacting to something familiar? Right? And so when something happens in the helping profession that you're in and you're feeling some kind of way, you ask, am I choosing to feel this way, or is this kind of autopilot for me? Am I reacting to something familiar? Am I looking for safety? Am I looking for adaptability? Am I looking to how I can change myself to survive in this moment? You also have to separate your empathy from your responsibility. So when you're in a helping position, you have a job description, and you need to do that job description, call it good enough, and leave some empathy for other people in your life and you. One of the things that has frustrated me is that I didn't have time or emotional energy for people that I actually have in my life that I love, people not patients that I love. And so you have to practice this good enough mentality instead of being indispensable, right? Like do your job good enough. And my character tells me to do it to the degree that my that that I want to do, which is way higher than my employer. And back to Dr. Hartney telling me you got to think of this as a slow leak and not a fire hose. She was saying it's okay for some water to keep dripping. So it's okay for some things to slip through the cracks, not safety things, but going over and beyond in the caring profession, it's okay to just stabilize the crisis and pass them on to somebody else. You also need to build relationships where you're valued for who you are, not for what you do or what you provide. And this is a tough one because many times people will hear that you have an expertise in something like trauma, and people are also always asking, which is great, it really is. But you need to surround yourself with people who don't care about the degrees on your wall or the knowledge in your head. They just love you for you. And they're not going to let you make self-effacing jokes, and they you need to surround yourself with people that love you for you. I cannot stress the importance of that. Because prevention of burnout isn't self-care, it's self-loyalty. It's you showing up for you, all versions of you, little you, middle you, adult you. It's you doing what nobody else would do for you, is show up for yourself. What if today you did one thing for yourself that you wish somebody would have done for you when you're just a small child? What if you did that every day? Prevention isn't self-care. Prevention of burnout isn't self-care, it's self-loyalty. Let's talk about recovery because that's where I am right now. Recovery isn't a weekend off. It's not a vacation that leaves you counting down until you return. Recovery often call requires a grieving process. Here's where I am: grieving the version of yourself that survived by being useful, right? So I made it through life by being useful. I don't need to be useful to the whole planet. Grieving the belief that caring more would make things safer. I couldn't make things safer in that moment where that one patient attacked the other patient. You need to grieve the fantasy that other people are going to protect you and are going to help you be overextended. If you work for somebody like that, fantastic. But I will tell you, when I did my doctoral dissertation and I spoke to physicians who treat patients after their discharge from the hospital, when I asked them about their organizational support to self-care, none of them told me that their organization supported their self-care. And these are psychiatrists dealing with heavy, heavy things. One of them told me, well, they give me an EAP program. That's not that's not supporting me in self-care. That's a benefit. And so you gotta go into these positions, understanding that no one, they're not gonna take care of you. You're gonna have to take care of yourself. And if they do take care of you, stay with them. That's a good one. Because, see, when you're like me and you have an A-score of nine, rest right now, in this moment, on February the 11th, does not feel restorative. It feels unsafe. Because in my mind, everything that I've done to be useful and helpful and effective and all of that is gone now that I can't be there. And so trying to rest does not feel restorative. It feels unsafe. What are they thinking of me? Am I gonna be able to go back? Is everybody gonna look at me? Um, am I gonna have to go back with that same intensity? And so I'm unable to rest in this moment, but we're getting there. Because when you grow up in crisis, stillness isn't natural. Like I'm used to to going fifty thousand miles an hour, and so being still is terrifying. And so working in a chaotic environment is familiar, right? That's what I grew up with. But your body can't keep up, as proven by what I have going on right now. Recovery was not about stopping. It's going to be about retraining my nervous system to understand. Here you go, guys, that I don't have to earn safety anymore. How am I earning safety by overextending myself? Right? Whether it's for the paycheck or acceptance or the or that I want to be useful. I've got to understand that I don't have to earn safety anymore, and that I'm the only one that's going to take care of me, and this is for you too. Recovery might look like tolerating disappointing people. Right? Right now I am thinking about all the people that must be thinking how weak I am. Recovery is going to be practicing boundaries when my body is speaking. This is not something that I did. I just kept going. Recovery might be letting myself be more impressive and more intact. Excuse me, less impressive. That did not sound right. Letting myself be less impressive and more intact. My healing will not make me less compassionate, and that's hard. Because I think that I have to physically be there doing things to be compassionate, but that too is not true. This healing is gonna make me less self-abandoning. Because here is the uncomfortable truth. Helping professions often benefit from trauma-adaptive people, and this is to my people that I work with. Helping professions often benefit from trauma-adaptive people, they are rarely trauma-informed towards the helpers themselves. Sad. And that definitely came out in my dissertation research when I taught to psychiatrists. You see, our our employers call it uh passion, they call it dedication, they call it resilience. Or as some said when I watched that patient altercation, that's just psych is what we sign up for. But is it? Sometimes all of that, right, that passion, that dedication, that resilience is just old attachment wounds working over time. And then when helpers like me burn out, the story becomes, ah, they just couldn't handle it. Psych's not for all people. But a better question is, and a better question for you listening to me, if you're in the helping profession. This is a big question. How long were they holding more than they were ever meant to? I want to say this clearly, especially if your story overlaps with mine. Your childhood trauma may have shaped your empathy, but it does not obligate you to suffer. You are allowed to care without collapsing, set boundaries without justification, step back without quitting compassion, choose sustainability over sacrifice. Healing isn't about caring less. It's about caring without abandoning and disappearing yourself. If you are listening to this and recognizing yourself, especially if you have a high A score, you are not broken. You adapted, you survived, and now you and I get to decide what thriving looks like. Even if it means redefining success. I hope that this has helped you guys. I know that it has me. Oftentimes, this microphone is a journal between me and the listeners. The bottom line is this. I grew up without the safety of caring, compassionate adults in my life. And I have turned into a performer who does have empathy, who does have compassion, but who is unable to separate my desire for people to accept my desire to people please with the fact that I go through life having learned to just adapt. And adapting is good when it needs to be, but there are times when life needs to adapt to us. And so, if that's where you find yourself, pay attention to my socials over the next several weeks as we're going to be talking about this burnout as it pertains to child maltreatment and trauma. And in a world where we are automatically taught to work harder and stronger and all the things, this isn't sustainable. And it is my motivation and my direction to help all of us, those of us in current burnout, those of you headed towards burnout, and those of you who have never burned out. Because your adaptation style will drive so much of how you live your life. And that causes unnecessary suffering to your body, your mind, and your spirit. So we'll be back in a couple weeks with Lauren Starns, who's a nervous system expert, and we're going to dive even more deeply into this burnout, particularly among helping professions. So for the next two weeks, I hope that you will remember that you are seen, you are known, you are heard, you are loved, and you are valued. See you in two weeks.

Culture Change And Asking For Support

SPEAKER_01 27:45

We all need, we all need the same thing. Someone to let us in. We all need, we all need a safe place. We don't have to defend. I'm not asking for all the pain in all the world to end. I'm just asking for a friend. From losing all you have And you're so afraid that you'll just lose it all again I'm just asking for a friend. Maybe you don't know the right thing to stay But trust me what she needs someone to stay. Someone to stay We home, we don't need to stay someone, we don't need We don't have to stand up in the world I'm just as important I thought But I don't know I'm still really friend I'm just asking for a friend. I'm just uh skipping for friends.