Episode 4: Burnout Isn’t Always Obvious

In this episode of Both Sides of the Couch, Kari unpacks the often sneaky onset of burnout, not just as a therapist, but as a human living with chronic illness. She shares how her definition of “enough” has evolved from grinding through nine clients a day to creating sustainable balance with a four-client maximum.

Kari reflects on how burnout doesn’t always announce itself with warning signs, sometimes it just hits, and other times it slowly builds through physical, emotional, or “health burnout,” where managing chronic illness becomes its own full-time job.

She offers insight into recognizing early warning signs, building a wellness plan, and using the “wellness wheel” to identify areas of imbalance before exhaustion takes over. Kari emphasizes that burnout can’t always be prevented, but it can be managed, with boundaries, community, and compassion.

✨ Takeaway: “You can’t manage burnout alone.” Check in with yourself, reevaluate your balance, and accept help, because no one can hold it all by themselves.

Transcript

0:02

Welcome to both sides of the couch. I'm Carrie, a therapist who also happens to be a human navigating chronic illness, which means I see life from both sides. This is where I share honest stories, lessons, and little reminders that you don't have to have it all figured out to keep showing up. Let's get into today's episode. Burnout doesn't always announce itself with flashing warning signs. Today we're talking about burnout. A state of emotional, mental, or physical exhaustion caused by stress. This is a common word in the therapy world. We were warned about it in grad school and it actually became an official diagnosis in the DSM in 2022. Way back when I first started my private practice, I was used to working in an agency where things were slammed and busy, and I would see up to nine clients a day, back to back sometimes with a lunch break, but no breaks in between clients these days I try to stay at four maximum. That's my sweet spot. Sometimes I do end up scheduling a fifth one, but. Nine is not on the table anymore and I hit burnout pretty fast. I look back and I'm like, what kind of therapist was I when I was seeing nine clients a day? And I remember saying to colleagues like, I feel bad for my last few clients'cause they don't get the best version of me. Why? That wasn't a huge blaring warning sign at the time. I don't know. But coming from agency life, I think you just think like, well, that's what it is. You don't have a choice. And I learned I do have a choice. I am the owner. I set the rules, I set the standard. And nine was not the standard. Eight was not the standard. Seven was not the standard. Five was okay. And now I'm kind of in a sweet spot with four on most days. Now with my health, that intro hook I had about. Burnout not always being a flashing warning sign that that can definitely be true for chronic illness. I know specifically for me, sometimes there's no warning signs and you just hit the ground and then you look back and you wanna say like, what did I miss? Surely I miss something. Sometimes my body just malfunctions. There's nothing that I missed. Other times there are warning signs. So it is important, it is helpful to look back to see if there's any warning signs, because sometimes you can notice that red light blaring and say, whoa, I better back up. I better slow down. So things like for therapists like supervision and consultation are really important because when you don't see the warning sign, somebody else will. And then when you hit burnout oftentimes it's hard to see yourself. So somebody else might notice it before you do. But I think for anyone with chronic illness, there's definitely like a health burnout that you get to. There's so many things you have to pay attention to all the time. Like I'm constantly tracking symptoms that's part of managing my chronic illness. And that's also part of your warning sign center. When you notice your symptoms ramping up or new symptoms happening, you kind of have to be like, Hey, let's look at this. Let's reevaluate what's going on. But also like the whole medical system, like going to doctor's appointments, not getting any answers, doing testing, not getting any answers, seeking out appropriate referrals, which can be really hard depending on where you live. Remembering to take all your medications, any other lifestyle habits you have to manage for your health, like you get burned out on that, especially with many chronic illnesses, you don't see the results that you're expecting to when you're managing everything properly. And I think a lot of times people do get to a point where they just give up. And stop doing all of the things that they know are gonna be helpful. I call that health burnout. Definitely like your burnout on managing. You need help, you need a change. But particularly I find like having a therapist that's knowledgeable in chronic illness to be really helpful for me, um, to not reach that burnout point as easily. So. The insider lesson with burnout is that it happens and even if we do our very best to prevent it, it may still happen to us.'cause some things are out of our control. So a really important thing to do is to make sure that we're monitoring and reevaluating it, like I said, as a therapist. We definitely need to have some sort of consultation, um, even if it's you more in a casual setting, chatting with your colleagues or friends that are in the profession. So we can help each other monitor and look for these warning signs for burnout or even just caution each other like, Hey, I hit burnout when this, when I was doing this, and maybe it's something we should look out for. I also find that having a personal wellness plan as a therapist, also as a person, and especially a person with chronic illness, is a really important tool for preventing and managing burnout because if you're not familiar with the wellness model. Um, the theory is based in balance, so there's usually about eight areas you can kind of pick or choose the areas that you wanna see in. I, I always say like, the eight areas are suggested and you can kind of tailor them to you or change the wording for how it fits you better. So there's things like physical, uh, emotional or mental relationships. Education environment, stuff like that. Uh, financial for wellness, anything that is a part of your life that you have to manage for personal wellness. So when you make this plan, there's a couple ways you can do it. You can do the wellness wheel where you draw out like a pie chart and how much energy you're spending in each area. Or you can use it like a simple goal. Setting exercise. So what I like to do is the simple part because it's too much work for me to do, really involved goal plans, just kind of like. Sketching out the areas that I want to focus on with the goal of finding better balance. So what will make me feel more balanced if I have to do all of these things? What can I do to kind of offset the stress from those? Um, but also helps me look at like where I'm spending too much time and effort. And that often can lead to burnout. And sometimes too, like if I'm just not feeling well and the physical's really unbalanced. Even though there's nothing I can do, it's just noticing that balance and anticipating, uh, the imbalance I guess I should say. And anticipating that that is gonna happen. It makes it easier to get through. And maybe during those periods I'm like, okay, I need to do more self-care. That's like, um. It feeds your soul instead of feeds your mind and your body like doing something that I really, really enjoy and not necessarily thinking about can my body handle this or is this part of the things like I have to do? Um, so for me, for example, um, I like being out in nature and sometimes physically it's probably not the best choice for my body, but for me, for my mind to prevent burnout and being in the same routine when I'm not doing well physically. Making sure that I can find a way that I can be out in nature actually does make me feel better because it's managing or preventing that burnout. So I highly recommend it, whether you do it with a friend or do it by yourself, and then kind of just constantly glance at it, reevaluate it, whatever, whatever works for you. I'm very flexible with goal setting because, goal setting works great for some people, I know that it doesn't work. That type of goal setting isn't gonna work great for everyone. So however formal or informal you need to make it, but making sure you remember to look at it. I keep it on my notes app, so I pull that note up every once in a while and I'm like, okay. Yeah. Or if I'm noticing like something feels off, I'm not feeling like myself pulling that wellness goal plan out and kind of reevaluating it can be helpful. So the key really is that we can't always prevent exhaustion from happening, but we can manage it. So burnout happens to varying degrees. We definitely wanna stay on like the lower end if we can. And sometimes you can foresee it coming or do not foresee it coming, but it's happening. And then all you really can do is manage it. Much like chronic illness, sometimes you can't prevent. Feeling bad. You can't prevent these physical things from happening, but you can manage them when they do happen. So I think coming up with some sort of like emergency plan for like, oh, I'm burnout. Here's how I'm gonna handle things, here's what I can do. Because when you're in the middle of burnout, you're not gonna be able to see, clearly the stress is gonna be too high. So as a therapist, my burnout plan is always taking time off. Um, if I ever got to that point. Taking time off, reducing my caseload if possible, taking things off my plate from work. So this extra stuff like writing or podcasting on the side, that's always like the cherry on top, so I don't always have to put the cherry on top. I can kind of leave that to the side. So making sure you have that kind of emergency plan mixed in a little bit with the wellness plan can be helpful too. So the practical takeaway I think is really just don't do this alone. Nobody can manage burnout alone. I think often people end up in a burnout state because they are doing too much by themselves. So. Whether it's a colleague or a friend or a support group or your therapist, I think talking about burnout and ways that you can manage it accept help where you can is always important. That's something we talk about as therapists and also something for chronic illness that's super important. Like nobody can do everything on their own. And I think if you're mindful of that, you will less likely find yourself in a place of burnout. Thanks for joining me on both sides of the couch. If something you heard today resonated, share this episode with someone who might need it. And if you'd like to support the show or find more of my work, check the links in the show notes. Until next time, take care of yourself on both sides of the couch.