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Even Your Therapist Is Tired

The constant state of high alert is exhausting. Here are ways to cope.

Fizkes / Shutterstock
Source: Fizkes / Shutterstock

by Stephanie Newman, Ph.D.

I hear about persistent fatigue at every turn. Friends, neighbors, and patients report that the Coronavirus pandemic leaves them more exhausted than ever before. Believe it or not, even therapists are tired, for the same reasons.

Jane (patient portraits are clinical composites), a thirty-something graduate student and mother of three, mourns the loss of her higher-octane, former self. “People called me the energizer bunny. Now, I’m more of a snail,” she says. “I used to get my kids up and out, play tennis, tackle cleaning, meals, and schoolwork help, and study at night after everyone was in bed. I still love reading to my children and can’t wait to get my teaching certification. But on a daily basis, I can barely put one foot in front of the other—that’s how spent I am.”

Bob, a forty-something performer, echoes Jane’s sentiments. He has, for several years, juggled professional projects while balancing time with his partner. But now “I have nothing left in the tank. I’ve spoken to the psychiatrist and it’s not a medication issue but something’s going on; I’m falling down exhausted. It’s a new kind of tired.”

I, too, am experiencing this “new kind of tired.” Transitions from clinical work to childcare flow seamlessly or skew messy and chaotic—like the time my son rattled the doorknob, shouting during a therapy session that the dog was having a colitis attack. Either way, fatigue sets in. While I don’t share with patients personal ups and downs, working from home during the pandemic has brought interruptions and background noise that strain my focus and concentration.

For the most part, I’ve managed to balance competing roles and responsibilities: moving from psychologist to homework helper, from writing obligations to cooking and, less frequently than I care to admit, cleaning. The frenetic pace once enlivened me, but my energy now lags. I am tired all the time. And to hear those around me tell it, I’m not alone.

What is causing collective fatigue?

What I’m describing isn’t mood-related, but a different animal entirely—a state of being emotionally drained and all around exhausted.

Science journalist Tara Haelle points to the depletion of our surge capacity, “the collection of adaptive systems—mental and physical—that humans draw upon for short-term physical survival in acutely stressful situations.” Faced with an indefinite pandemic, unable to problem-solve in ways we normally would, we are bereft.

Related explanations for exhaustion include pandemic fatigue, stemming from months-long worry about the coronavirus and its potential adverse impact on all aspects of daily life, and coronavirus burnout, following months of taking safety precautions.

It isn’t just outward conditions and our reactions to them that are tiring; anxiety is itself depleting. If conceptualized as a signal of imminent danger (Freud 1926), the effects of persistent stresses and fears become clear. We are solidly in it, trapped in a pandemic which brings illness, death, and loss, as well as uncertainty and a never-ending state of awaiting a vaccine. We are left with our own dread, asking: will sickness come, and will it bring another round of closures?

More than just the health crisis

An unrelenting cycle of bad news about political, economic, and social issues presents challenges to our maintenance of emotional well being. It is as if we are in a state of “fight or flight,” our stress hormones elevated. We anticipate a danger that never remits and experience a perpetually heightened anxiety. Our lack of understanding and control and the virus’s unpredictability exacerbates our anxiety and leaves us helpless (Haelle) in the face of many unknowns. Unable to foresee who will become ill or explain why some perish while others develop milder cases, we search for answers, worry, and ruminate.

Science shows that thinking and cognition are in themselves tiring. In a recent study, researchers found that while physical exhaustion and emotional depletion are both at play, the perception that what lies ahead would be overwhelming, was also a factor in cognitive fatigue.

Such notions of cognitive fatigue and anxiety bring us full circle. We have existed in a perpetual state of high alert, waiting for a danger that never passes. Our chronic anxiety and unremitting worry pack a one-two punch, creating conditions rife for the overwhelming exhaustion so many are experiencing.

What to Do?

  • Find ways to become aware of sources of stress.
  • Identity and pay attention to exhaustion you’re feeling. Consider the nature of all underlying causes such as chronic stress, worry, and waiting for a release that never comes.
  • Make small choices each day that allow you to replenish—step out of meetings or make time in between to clear your head. Stretch and exercise regularly, try yoga, and keep a gratitude journal.
  • Practice self-care. Train your mind to slow down, monitor and combat anxious thoughts. There are many free mindfulness and meditation apps that help with this.
  • Sleep well and eat a balanced and nourishing diet.
  • Consider seeking help from a psychotherapist or psychoanalyst. If you are feeling hopeless or unable to experience interest or pleasure, or having difficulty with sleep or appetite, these might be signs of more serious mental distress.

The author wishes to acknowledge Stephen Malach, M.D., for his ideas about Covid-19 and associated anxiety.

Stephanie Newman, PhD, a psychoanalyst and author of Barbarians at The PTA, is a Visiting Scholar at Columbia University, as well as a member of PANY and of ApsAa’s Committee on Public Information.

References

Freud S. (1926). Inhibitions Symptoms and Anxiety, in Strachey J., Standard Edition Volume XX (1925-1926): An Autobiographical Study, The Question of Lay Analysis and Other Works, 75-176.

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