Burn-out, Compassion Fatigue and Transference

I have been struggling with my new job this past week intensely and it has taken me some time to organize my thoughts. This past week my meltdowns have had everything to do with the coworkers, and nothing to do with the patients. That's a good diagnostic tool for indicating a major internal problem for the institution, I feel.

The problem is not that my coworkers are bad people. Quite the opposite, actually. They are wonderful people and I have fell into friendship or rather professional camaraderie with them with ease. I admire them as individuals, I admire their life and professional track records. It stops there. It used to make me frustrated but now I just feel extremely angry on this point.

One coworker, working as a contractual employee (fancy wording for more skilled temp workers) complains constantly about how horrible Johns Hopkins is to work for, how tough our particular unit within Johns Hopkins is, and how it is bum-luck to be a therapist all together. I have deduced from his complaints that really he is unhappy about not having benefits from his contracting management company (transference), exhausted from the number of patients on his case load (burn-out) and running out of sympathy for a population in substance abuse he has based his professional career upon (compassion fatigue).

A second coworker, working into her third year in this unit of Johns Hopkins cannot stop putting down the program she works for as "horrible" with terrible management and as a "ceiling-job" or job you just take for awhile before jump-starting to your actual career. Deducing her statements I found she is just carrying almost twice the caseload she should (burn-out), is rewarded minimally as all therapists are, but with no training to help her deal with this (transference) and with no training on this topic either, over empathizes with her patients to the point where she can be cold and unfeeling towards them and others now (compassion fatigue).

A third coworker, finishing her first year, worked 9 years previously for Baltimore City Department of Social Services. She believes this job to be easy to get and a huge backward step in her career; a holding place for her while she goes to school to get other certifications. I don't need to break down where her horrible attitude is from. All three problems (burn-out, compassion fatigue, and transference) probably happened in her first two months at DSS.

So enter brand new employee, freshly licensed, fresh out of grad school, ecstatic to begin her professional career with Johns Hopkins with other hard-working, highly qualified professionals surrounding her. Finally the hard work, money, hard work, studying, hard work, job interviews and hard work have paid off. In the first month, other than a complete lack of training or support of any kind, she hears from her coworkers she is at a dead-end job that requires no special knowledge, certification or trainings which is basically a holding place for many and a giant step backward for her, working for the horrible agency in the worse employer, Johns Hopkins. Leave it to the new, frazzled and heartbroken employee to be a professional, trained therapist to break down the feelings communicated and deduce the actual culprits. Not Johns Hopkins, not the unit, not the management, but our good old friends burn-out, compassion fatigue and transference. Not that it helps a whole heck of a lot to know this and still be stuck in this horrible working environment.

My sister gave me some good insight to all of this. She said, and I agree, that it doesn't matter who works around you. It doesn't matter what their attitudes are, what their licensing is (or isn't) or how they try to bring you down. What matters in the end is what you came there for: to help women that are in need. Regardless of the qualifications of others, I have to have confidence that my qualifications make me better trained to be able to meet that goal and avoid the three things that so quickly decapitate a less well prepared therapist. Pride be damned!

The ironic thing is, and in school they do not teach you this, the attitudes brought on by my coworkers are transferable to me if I do not pay attention to them and deal with them in the appropriate way. Much as I believe theirs has been, my vision can be skewed to make my own self miserable. Their anger and disdain and negativity can create transference in me of my job only one short month in. Their attitude has the potential to ruin it all; burn me out and get me on board their sinking ship, and in time, I believe that it will. There are only so many times you can be hit and remain standing.

So what to do?

Why, Baltimore?

Why, Baltimore, do you sell drugs for pain and suffering? Drugs for stealing, drugs for sex, drugs for more drugs and money?

Why Baltimore, do you sell drugs to your children and have children selling your drugs?

Why, Baltimore, do you sell drugs to your pregnant women, to your women whom you abuse and get pregnant? To the babies in their addicted mothers who are born addicted?

Why, Baltimore, do you fill your streets with pain and poverty, AIDS and tragedy? Murders, suicides, overdoses and somewhere in between?

Why, Baltimore, do you foster racial hate, sex and gender hate and hate for no reason at all?

Why, Baltimore, do you fill your cold empty streets, your dirty and condemned row homes, your vacant and crumbling buildings with crackheads, addicts and the homeless?

That you helped create?

For those who were born into drugs. Those born into poverty. Those born into the streets.

For those abused by their loved ones, those abused for love. For all those lives ruined by all types of abuse.

For those that know nothing else. For those doing only what they know. For those using all they have ever experienced to stop their pain.

Find yourself out of the pain of the city.

Reach towards those that love you. Reach towards those that will always be there for you. Reach for those who gave you a chance.

Reach towards someone who has been there before. Reach for someone who has succeeded. Reach for someone clean from using, healed from hurting and working for something better.

Reach for those that want to help you. Reach for professionals who give their careers and lives to help you. Reach for programs, reach for churches, reach for caring and safe strangers.

Reach for change and don't give up. You will find yourself in a different city.