Awareness Won't Protect You: Why Self-Aware Therapists Still Burn Out

When burnout looks different: ADHD, neurodivergence, and the helping profession

Episode Summary In this episode, Stacey Steele draws on her own experience as a psychologist diagnosed with ADHD as an adult, and a growing body of research, to explore the specific intersection of neurodivergence and occupational burnout in helping professionals. If you are currently experiencing clinical impairment or a mental health crisis, please reach out to your regulatory body’s peer support program, a trusted colleague, or a mental health professional of your own. Stay in the conversation The ReLit Practice 12-week program waitlist is open, enrollment begins July for the September Cohort https://www.relitpractice.com/workwithme [https://www.relitpractice.com/workwithme] Before then, book a free Practice Sustainable Snapshot: https://calendly.com/relitpractice/practicesnapshot [https://calendly.com/relitpractice/practicesnapshot] Find Stacey at the Reset Circle each month, a free monthly peer gathering for cliniciansnhttps://www.relitpractice.com/circle [https://www.relitpractice.com/circle] Research Referenced * Executive function deficits mediate the link between ADHD and job burnout [https://pmc.ncbi.nlm.nih.gov/articles/PMC11007411/] * Emotional dysregulation as a core symptom of adult ADHD [https://pmc.ncbi.nlm.nih.gov/articles/PMC9821724/] * Experiences of medical students with ADHD [https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0290513] * ADHD in medical students and professionals — qualitative phenomenological study [https://pubmed.ncbi.nlm.nih.gov/41312647/] * Stress and work-related mental illness among working adults with ADHD [https://pubmed.ncbi.nlm.nih.gov/36451126/] * Strengths and challenges of ADHD in employment — systematic review [https://journals.sagepub.com/doi/10.1177/27546330241287655] * Workplace interventions for burnout in healthcare — systematic review [https://pubmed.ncbi.nlm.nih.gov/37385740/] * Neurodiversity in the healthcare profession [https://pubmed.ncbi.nlm.nih.gov/39209457/] * Career sustainability and adult ADHD diagnosis [https://www.emerald.com/cdi/article/30/7/796/1303061/When-work-context-limits-opportunities-for-career] * Neurodiversity and inclusive workplaces — health disparities [https://ojs.brazilianjournals.com.br/ojs/index.php/BJB/article/view/76666] * Working sustainably with ADHD or autism in the workplace [https://pubmed.ncbi.nlm.nih.gov/36379218/] * ADHD in medical learners and physicians [https://pubmed.ncbi.nlm.nih.gov/37131931/] * Systematic review: ADHD prevalence in medical students. (Lee & Zhang, 2025. Frontiers in Psychiatry.) [https://pubmed.ncbi.nlm.nih.gov/41409340/]

Mythbusting Therapist Burnout

In this episode, Stacey Steele, R.Psych., takes on five of the most persistent and clinically consequential myths about burnout in the helping professions and replaces them with what the research actually shows. Drawing on recent empirical literature and honest personal experience, this episode reframes burnout as a nervous system and systemic response, not a personal failing. Stacey distinguishes burnout from secondary traumatic stress, compassion fatigue, moral injury, and depression, and makes the case that sustainability in clinical practice requires both individual restoration and structural accountability. Tools mentioned in the episode The PHQ-9 and the Professional Quality of Life (ProQOL) survey for formal tracking. The Greenspace Health platform for outcome data. The Bearable app for symptom and lifestyle tracking. And for the already-tired: a Post-it on the laptop, an energy rating at the end of each day, thirty days of data. Stay in the conversation The ReLit Practice 12-week program opens enrollment for the September founding cohort in July, with special pricing for the first eight clinicians. https://www.relitpractice.com/workwithme [https://www.relitpractice.com/workwithme] Before then, book a free Practice Sustainable Snapshot twenty minutes to look at one thing you could change this week to feel even ten percent more sustainable. https://calendly.com/relitpractice/practicesnapshot [https://calendly.com/relitpractice/practicesnapshot] The Reset Circle is a free monthly peer gathering for clinicians. Come once or come every month. https://www.relitpractice.com/circle [https://www.relitpractice.com/circle] References Cited Bianchi, R., & Schonfeld, I. (2024). Beliefs about burnout. Work & Stress, 39, 116–134. [https://www.tandfonline.com/doi/full/10.1080/02678373.2024.2364590#abstract] Brindley, P., et al. (2019). Psychological ‘burnout’ in healthcare professionals. Journal of the Intensive Care Society, 20, 358–362. [https://journals.sagepub.com/doi/10.1177/1751143719842794] Camargo, G., et al. (2021). Psychological exhaustion of nursing professionals. Revista brasileira de enfermagem, 74. [https://pubmed.ncbi.nlm.nih.gov/34037175/] Hoffarth, M. (2017). The making of burnout. History of the Human Sciences, 30, 30–45. [https://journals.sagepub.com/doi/10.1177/0952695117724929] Ledingham, M., et al. (2019). ‘I should have known.’ Asia Pacific Journal of Counselling and Psychotherapy, 10, 125–145. [https://www.tandfonline.com/doi/full/10.1080/21507686.2019.1634600] Montgomery, A., & Maslach, C. (2019). Burnout in health professionals. [https://pubmed.ncbi.nlm.nih.gov/31362957/] Smajlović, A., & Budler, L. (2025). Burnout and the stigma of help-seeking in nurses. Acta psychologica, 261. [https://www.sciencedirect.com/science/article/pii/S0001691825011059?via%3Dihub] Yang, Y., & Hayes, J. (2020). Causes and consequences of burnout among mental health professionals. Psychotherapy. [https://psycnet.apa.org/doiLanding?doi=10.1037%2Fpst0000317]

Awareness Won't Protect You: Why Self-Aware Therapists Still Burn Out

Most clinicians have been trained to be exquisitely self-aware. Few have been trained in what to do with what they see. In this episode, we look at what the research actually says about therapeutic self, self-awareness, and burnout and why awareness, on its own, doesn't protect you. We distinguish burnout from secondary traumatic stress, moral injury, and PTSD. We examine why self-compassion (not self-monitoring) shows up as the consistent buffer across studies. And we name the structural conditions no individual practice can substitute for. The Reset Circle™ is a free, online, monthly gathering for therapists and other helping professionals navigating burnout and the weight of practice in demanding systems. Each 60 minute circle includes a brief masterclass on topics that matter in and out of the session, a guided grounding practice, and an opportunity to reflect and share (always optional!). But mostly, this is a space you can actually exhale in with people who get it. The next one is May 12th at 7pm EST where the topic is "Bringing our whole self into the therapy room". All parts of you are welcome! Save your seat and register here: https://www.relitpractice.com/circle [https://www.relitpractice.com/circle] ───── Referenced research (linked): Exploring the use of the therapist's self in therapy: A systematic review.https://doi.org/10.1177/02537176241252363 [https://doi.org/10.1177/02537176241252363] The soul of therapy: The therapist's use of self in the therapeutic relationship. https://doi.org/10.1007/s10591-021-09614-5 [https://doi.org/10.1007/s10591-021-09614-5] The benefits of self-compassion in mental health professionals: A systematic review of empirical research. https://doi.org/10.2147/prbm.s359382 [https://doi.org/10.2147/prbm.s359382] Effective burnout prevention strategies for counsellors and other therapists: A systematic review and meta-synthesis of qualitative studies. C. https://doi.org/10.1080/09515070.2024.2394767 [https://doi.org/10.1080/09515070.2024.2394767] Self-compassion explains less burnout among healthcare professionals. Minhttps://doi.org/10.1007/s12671-020-01469-5 [https://doi.org/10.1007/s12671-020-01469-5] Love yourself as a person, doubt yourself as a therapist? . https://doi.org/10.1002/cpp.1977 [https://doi.org/10.1002/cpp.1977] Psychologists' engagement in reflective practice and experiences of burnout: A correlational analysis.https://doi.org/10.1080/14623943.2022.2090326 [https://doi.org/10.1080/14623943.2022.2090326] (2020). Impact of the therapist's "use of self." . https://doi.org/10.5964/ejcop.v8i1.160 [https://doi.org/10.5964/ejcop.v8i1.160] The mediating role of self-compassion between mindfulness and compassion fatigue among therapists in Hong Kong. https://doi.org/10.1007/s12671-016-0618-5 [https://doi.org/10.1007/s12671-016-0618-5]

Therapists, Is the Boundaries Conversation Gaslighting You?

You've heard it. You've said it. "You just need better boundaries." But what if the boundary conversation has become part of the problem? In this episode, we explore how self-sacrifice and unrelenting standards schemas, two of the most common patterns in helping professionals , can turn well-meaning boundary advice into a shame spiral. Drawing on Jeffrey Young's schema therapy model and Skovholt and Trotter-Mathison's Clinician Paradox, we unpack why the same qualities that make you effective in clinical work are the ones that make saying no feel genuinely dangerous. This isn't an anti-boundary episode but acknowledges that burnout doesn't mean a boundary failure. You spend your life holding space for others but where do you go when you're exhausted and need it held for you? When the very nature of therapy is about giving and caring, it’s easy to forget about what we need! And when the structures we work in (even private practice) aren’t designed to hold space for us, burnout becomes real. I see this all of the time in my burnout recovery work with therapists and other helpers, they are excellent clinicians and even “do all of the things” for self care, but are still tired. It's because we can't do this alone. That's why I created the Reset Circle, because the number one agent of burnout prevention and recovery is being with peers who get it. Not bubble baths, more CE's, or boundaries. But connection. The ReLit Reset Circle™ is a no cost, monthly gathering for therapists who want to stay in this work without losing themselves, while navigating burnout, moral strain, and the emotional weight of practice inside demanding systems. Our next gathering is April 14th 7pm EST where our topic will be “Being Good Enough”. This month's Reset Circle explores the Unrelenting Standards schema and why the clinicians most committed to excellence can fall into the trap of the endless pursuit of excellence which can be another mask for burnout. We will look at the impact of overfunctioning and what it looks like to practice “enough-ness”. Register here: https://www.relitpractice.com/circle [https://www.relitpractice.com/circle] References & Links: Young, J. E., Klosko, J. S., & Weishaar, M. E. (2003). Schema Therapy: A Practitioner's Guide. Guilford Press. https://www.guilford.com/books/Schema-Therapy/Young-Klosko-Weishaar/9781593853723 [https://www.guilford.com/books/Schema-Therapy/Young-Klosko-Weishaar/9781593853723] https://www.routledge.com/The-Resilient-Practitioner/Skovholt-Trotter-Mathison/p/book/9781138830073 [https://www.routledge.com/The-Resilient-Practitioner/Skovholt-Trotter-Mathison/p/book/9781138830073] https://onlinelibrary.wiley.com/doi/10.1002/cpp.70115 [https://onlinelibrary.wiley.com/doi/10.1002/cpp.70115] https://www.ncbi.nlm.nih.gov/books/NBK614517/ [https://www.ncbi.nlm.nih.gov/books/NBK614517/] https://www.guilford.com/books/DBT-Skills-Training-Manual/Marsha-Linehan/9781462516995 [https://www.guilford.com/books/DBT-Skills-Training-Manual/Marsha-Linehan/9781462516995] https://www.sciencedirect.com/science/article/pii/S2213058614200179 [https://www.sciencedirect.com/science/article/pii/S2213058614200179] https://onlinelibrary.wiley.com/doi/10.1002/cpp.2328 [https://onlinelibrary.wiley.com/doi/10.1002/cpp.2328]

“I’ve done all the right things, so why do I feel this way?”

If you’re a clinician providing therapy, how many times today have you used the word “boundaries”? Likely in the context of working with someone in their relationships or helping someone try to get more balance in their life. Now, in your professional context, what comes up when you think of boundaries? Maybe your ethical code and standards of practice, your schedule, client contact (or if you’re like me, always working on ending sessions on time!). You've probably even read the articles. You might have even written one. "Ten Self-Care Strategies for Therapists." "How to Prevent Burnout in Clinical Practice." "The Importance of Boundaries for Helping Professionals." You have likely done most of what they suggest too. You exercise, go to your own therapy, do the breathwork. You read the books, take the trainings, get supervision. You set boundaries, at least you do your best. You do what you’re supposed to do. Then why are you exhausted? I hear this question all the time from mid-career clinicians, the ones with seven, twelve, or eighteen years of experience. The ones who have enough clinical skill to do complex work, supervise others, and who have enough self-awareness to know something is wrong but internalize it as they are the ones doing it wrong. What if the problem isn't your self-care? This is the first episode in a multi-part series on clinician sustainability, building on earlier episodes exploring moral injury and the systemic forces shaping clinical work. Reflection Prompts 1. When you say you're "burned out," what are you actually describing — exhaustion, shame, grief, or a values violation? 2. Which of the four constructs (burnout, secondary traumatic stress, vicarious traumatization, moral injury) most closely maps onto what you're carrying right now? 3. Is your current practice designed for sustainability or for output? Whose interests does that design serve? 4. Where do the Self-Sacrifice or Unrelenting Standards schemas show up in how you relate to your work? Connect You hold space for others but where do you go when you need it held for you? Join me at the ReLit Reset Circle™ A no cost, monthly gathering for therapists who want to stay in this work without losing themselves, while navigating burnout, moral strain, and the emotional weight of practice inside demanding systems. Next gathering is April 14th 7pm EST where our topic will be “Being Good Enough”. Register here: https://www.youtube.com/redirect?event=video_description&redir_token=QUFFLUhqbUVXeHJlZUQxZExsUU85ZkQwa3l4TXd6TEN3Z3xBQ3Jtc0tsSkRPVzBFYjB6bVZJZEVraExBVE9ZbUVFRWkwYV9aYmw5Skw4SWZBRTFfbnNKTFI3d1JsMGFydG1KMk0xUElsbFdaT05ySDIzd3RwaHFDZDVlUlVuS1RESWliOFBYUUNsMWJFaHRKbC1Bek8yYnpITQ&q=https%3A%2F%2Fwww.relitpractice.com%2Fcircle&v=4cggNXB-9QEhttps://www.relitpractice.com/circle [https://www.relitpractice.com/circle] Registration gives you access to the replay, subscription to the ReLit Practice Newsletter where I share topics about therapist burnout recovery, moral injury, trauma informed care, and how to stay in this work without losing yourself! When you register, you'll also get access to the free Reset Checklist, a practical starting point for noticing where your system is right now, and you'll be first in line when doors open for the ReLit Practice program.