Note: I want this post to land in a caring way, and not an angry way. But maybe angry needs people to care.
I think it would be fair to say that I am currently in the deepest portion of the empathy burnout spectrum that I have previously here-to-fore inhabited. Maybe that’s why I’m considering a post comparing the types of people I’ve supported at work. I don’t think mental health workers get enough support. So let’s talk about burnout, which is what I’ve been dealing with lately.
I.
Regarding my burnout, I suspect a contributor to this would be a poly-wham of global crises at least. These would be joined by non-descript personal troubles which for personal reasons need not be described, and a sinking suspicion that the sector I’m laboring in has parenthetically suppressed all those really honest human feelings of ambivalence toward fellow man.
Probably this is in an attempt to curry funding. But with the consequence that in a sick psychoanalytic upside-down sort of way the repression of this tendency re-emerges in the form of a different tendency: a tendency towards actively hating any and all authenticity, genuine sentiment, or emotional tenderness. Because those emotions are ugly and they don’t have a crisp edge. Though that doesn’t mean I don’t think they aren’t vital. They need to be acknowledged, no?
Otherwise, as though in some backward repression the repressed could repress the repressor for that which it is repressed. The darkness comes back up because you didn’t treat it right. The shadowy part of the human soul might come and subdue the higher values for which it was subsumed, to begin with.
But this rant is mostly orthogonal to the point I want to make, which is that I’m tired, and that working in a field where all you do is care for people all day is extraordinarily difficult, and that I’m not interested in pretending otherwise. I want to say this out loud so that I can do something else about it afterward.
II.
It is extraordinarily difficult to be so genuinely down on your luck in an inescapable way so that it requires the government to pay me to care for you. This usually will not happen unless you are either so alienated, introverted and silent you can’t find anyone else to take care of you or you are so insufferable, aggressive and hurtful that you can’t find anyone else to take care of you because you keep hurting them.
The most fun thing about the left horn of this dilemma is that the alienated introvert types will spend most of their time not ruining my day whereas the people on the other side of this spectrum need to ruin my day to feel okay.
I am still on the fence as to whether or not the people for whom being the worst is a survival strategy can be justifiably blamed for being how they are. The best argument against it is that they could never have helped being how they were because, in all of my experience, the people like this were the most horrifically traumatized individuals I had ever met.
As was once explained to me by a supervisor, the most damaged and difficult people will actively hate your attempts to care for them, especially if the people who traumatized them the most were people from whom they accepted or from whom they actually at some point received care. That this is heartbreakingly tragic is one thing. The other thing is that it makes them hate me for doing my job.
Often times, these people did not request to be put in the position where I need to be taking care of them. Often times, it comes from a need to eat food and have a roof as well as a bed. Or other times it came from a need on the part of the government to have someone making sure they take their meds on time or else.
III.
Let’s immediately dub the aggressive types type A, silent introverted types type B, and genuinely just awkwardly down on their luck people whose circumstances are extreme but are otherwise fine people type C. I’ve known lots of type C’s, and the worst parts about their stories for me was just how long it took them to get actual help.
Taken in terms of natural selection, a given population of people who need some help are going to be helped if anyone is around to help them who can. Assume a distribution of even type A’s, B’s, and C’s. Over time, type C’s will get hoovered up. It might suck for them because it will take time for the powers that be to realize they aren’t type A’s, and they will also seem far more competent than type B’s, so nobody will think their circumstances were that dire. But they’ll still get sucked up.
Then you get type B’s helped out. They don’t cause any trouble for anyone, so they take about an eighth of your work time in my experience.
So that leaves a pool where type B’s get sorted once and never come back or if they do they never cause any trouble. Then the type C’s get helped out once and never need it again– because they just needed help the one time to overcome the circumstances. The problems had never been them. So we’re left with the type A’s, who need to be emotionally violent to feel safe. They’re the people you hear about on the revolving door of social care.
I don’t know how to love those people the way that the Sermon on the Mount would tell me to, and I don’t know how to deal with that in an anyway functional way.
So I suppose the most emotionally adroit response that remains would just be to talk about it on the internet, to no-one in particular and then pray this never gets connected to my actual name, so I won’t get Scott Alexander’d or need to do it myself.
But I also think the risk to me would be justified, if only other professional reads this and realizes that nobody can make it through a whole career in this field in without those feelings. That’s my conclusion for how just the last year has been.
Or maybe I’m wrong and I’m the only one who gets mad. Though I know that when I do, and when I let myself, I can come back tomorrow and be a lot more kind than I could have before. So it can’t be all bad.
I’ve spoken to doctors and to nurses, and I figure that if they can justifiably feel rage and the hurt people they’ve charged themselves with then I’m just as justified with this sort of position; with this sort of honesty.
A word in my own defense I guess, because I feel sort of heinous: it helps me do my job better to be direct at least, so forgive me there, okay?
NOSIARCH 