Back from Burnout
It’s been a while since I’ve written here – let me explain my absence. Early this year I began to recognize the signs of something resembling burnout in myself, and decided to take the advice I often give to my patients, to take a step back from some of my activities and responsibiilities in order to focus more on my well-being. The activities I chose to give up were writing blog posts and newsletters, teaching online mindfulness classes, and taking new patients.
At the time I thought this “break” might last for a month or two, but as it turned out, I needed much longer to heal and restore what was depleted in me. It wasn’t as simple as “get more rest,” nor was it about setting boundaries or saying no to excessive demands on my time. That’s the prescription for typical burnout, but this was a different kind of emotional exhaustion. I practice what I preach about self-care, so I was getting plenty of sleep, regular exercise, and healthy nutrition, and I’ve got good boundaries. Then why was I so exhausted?
I am a “silver lining” person, usually able to find the good or beneficial even in the worst of circumstances, and I had been doing that for the first year of the pandemic, but then it stretched into two (now three) with no clear end in sight. Those first months of the lockdown were hard, but there was a sense of “we’re all in this together” that made it feel more like an adventure. Then when vaccines became available, there was a sense of relief, and hope that this would be over soon. Instead, it got worse, fueled in large part by all of the people who refused to get vaccinated, mostly for reasons that made no sense to me. I no longer felt like we were all in this together.
I am also a person who has always felt a deep connection to Mother Nature, and when my batteries need recharging, I head to the woods, or the ocean, or just my garden. During the lockdown, I was grateful to have a yard and garden, and to live in a neighborhood that’s safe to walk in, where I could access trails into the hills. I was able to spend more time outdoors, which helped, but it’s also depressing to try to grow things during a prolonged drought, and with all of the extreme weather events (remember that day in August 2020 where the sun never came out, and it felt like we were on Mars?) Forest fires, hurricanes, floods and mudslides – we are experiencing the harsh reality of what our reliance on fossil fuels has done to the planet, and yet, people aren’t changing their habits, and fossil fuel companies have doubled down.
On a related note, I’d been working hard to maintain my optimism for the benefit of my patients and students, as well as colleagues and friends, all throughout the dark years of the previous administration. But here we are, still living under that dark cloud six years later, with nearly a third of adult Americans still believing the lies about a stolen election and voter fraud. Those lies and the people who promote them threaten the very foundations of our democracy.
As I write that last paragraph I realize I risk losing a few of you as readers, which points to one of the gravest concerns that I have about the world we are living in today: we seem to have lost the ability to even listen to, let alone respect differing views, opinions and perspectives. That factor alone has affected my motivation to write, because I believe what makes something worth reading is its potential to stimulate thought, challenge existing views, and offer a new perspective. And I simply can’t pretend things are okay when they are definitely not okay.
My training as a psychotherapist was traditional, in that I was taught to keep my personal views and opinions separate from my work with patients, and to not share anything about my personal life. When I was a young therapist, still in therapy myself to heal my own childhood wounds, that proscription suited me nicely. But over time, as I healed and matured, and as the field of psychotherapy itself changed, I began to share more of myself with patients. I brought my experience with therapy, 12-Step programs, and mindfulness meditation into sessions. I “showed up” for my patients in a new way, which not only felt more authentic for me, but also allowed the work we were doing together to go to a deeper level. This was more satisfying for me as a therapist, and led to deeper levels of insight and healing for my patients.
I experienced a similar sense of satisfaction teaching mindfulness classes, as I was able to observe my students struggle with the practices week after week, and then suddenly have an “aha” moment that was transformational, perhaps life-changing. Even when I was teaching in the evening, after a long day of seeing patients, I would come home feeling grateful to be doing this work.
But the satisfaction, gratification, even joy that I experienced from my therapy sessions and mindfulness classes began to dissipate once everything moved online. I didn’t notice this right away, as I was so busy just mastering the technology, and relieved when it all worked and we could see and hear each other. And I was glad to be able to still provide support to my patients and students, as we all struggled through that initial phase of the pandemic.
Soon it became clear, however, that something was getting “lost in translation.” A day of Zoom sessions would leave me depleted, rather than nourished. Many of my colleagues noticed this, too (though I wasn’t seeing my colleagues in person anymore, either). Eye strain was part of it, as was the distraction of seeing myself as well as my patient on the screen. Phone sessions were easier in a way, and yet the challenge remained one of establishing a genuine connection. Telehealth can easily become simply a check-in. I noticed that mindfulness classes became more superficial, too. It’s difficult to dig deep into someone’s experience when you can’t see what’s happening in their body.
What I’m getting to here is what I’ve come to understand as a primary cause of my burnout: the loss of personal connection. Zoom and FaceTime are great tools that clearly have value as a way to connect, and I appreciate their convenience, but I think we’ve all come to realize that something gets lost, and that something is an intangible, hard to measure or define, energy. Without getting all “woo woo” I’ll just say, science has shown us humans are energetic beings, and we are biologically hardwired to read each other via “body language.” We also need each other’s physical presence for emotional regulation. We are “wired for touch.”
There’s another piece here for me, which is so personal that I’m hesitant to share it. During the past two years both of my adult sons moved to the East Coast, one of them taking my new grandson with. Talk about a loss of personal connection through touch! I wholeheartedly supported their moves as being right for them, and was able to appreciate what the Buddhists call “sympathetic joy,” when you’re happy for someone else’s happiness, even if it may cause you unhappiness. But still, it’s been a loss, one that I know many of you can relate to.
It’s not just my own lost connections that depleted me. As an empathic and highly sensitive person, I have felt a collective grief for the loss of millions of lives to COVID (a trauma that we have not fully acknowledged as a society). And I feel the effects of the many ways in which all of us have become isolated and disconnected from each other, both as a result of the pandemic as well as the polarized political climate. The positive energy I had once felt from the #MeToo movement and Black Lives Matter dissolved into despair, as women’s rights and BIPOC rights are increasingly threatened everywhere, ultimately at the level of the US Supreme Court.
There are objective data that confirm this societal trauma: we’ve seen significantly higher rates of anxiety, depression, substance abuse and suicide, not to mention increases in domestic violence and gun violence, over the past couple of years. Besides political and economic factors, there’s a biological explanation for this too: when human beings lose their sense of connection with other humans, despair, hopelessness and alienation take over.
I didn’t arrive at this self-diagnosis until after I’d already embarked upon its cure. Sometimes we can only see clearly in hindsight; action is necessary before insight appears. As I began to see more patients in the office, led a few mindfulness meditation groups in-person in the park, and finally felt safe enough to travel to visit my sons and their families, my personal dark cloud began to lift. I also focused on “changing the things I can,” as the Serenity Prayer reminds us. This turned out to involve a move to a new home, with a dedicated and Zoom-friendly home office (after two and a half years of improvising) as well as a last-minute decision to find a way to keep my Pleasanton office, which I’d barely been using. Both decisions required navigating through uncertainty and letting go of control, but ultimately feel right.
Now I’m gearing back up to see patients two days a week in the office, following COVID protocols, while continuing to offer telehealth sessions the other weekdays, which feels like a more sustainable balance. I am also planning some in-person mindfulness classes for 2023, starting at Las Positas College in January-February. Today I’m meeting some new colleagues for lunch. And I am really looking forward to taking a week off next month for my first in-person meditation retreat in several years!
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Burnout in the Helping Professions
“There’s no shame in taking a step back to focus on self-care.” As I was saying this to one of my clients recently, it hit me: if I truly believe that, then I need to practice what I preach! It was obvious to me that my client was suffering from burnout, due to the demands of her job as a mental health professional as well as her family caregiver responsibilities, and equally obvious that she absolutely deserved to set some boundaries, ask for help, and take a break to recharge her batteries. And yet, even though I was beginning to see signs of burnout in myself, it was a real struggle to acknowledge this, and give myself the same permission to step back.
This is the dilemma that many of us in the helping professions face: if you’re a nurse, doctor, psychotherapist, social worker, or teacher, you may have received training to recognize the signs of burnout, and you may know what to tell your patients, clients, or colleagues to do to relieve it. In fact, you might spend your days counseling others to take a step back, set some boundaries, reach out for help, and get some rest. But when it comes to you, you’re far more likely to tell yourself to just push through the exhaustion, and ignore the growing cynicism and feeling of detachment from the work that you used to love.
So what exactly is burnout? The World Health Organization (WHO) defines burnout as “a syndrome resulting from chronic work-related stress, with symptoms characterized by feelings of energy depletion or exhaustion; increased mental distance from one’s job, or feelings of negativism or cynicism related to one’s job; and reduced professional efficacy.”[1] It is not a medical condition or mental disorder.
Christina Maslach, professor emerita of psychology at UC Berkeley and co-author of the Maslach Burnout Inventory (MBI), describes burnout as “feelings of exhaustion, inefficiency and cynicism, defined by a detachment from work and a lost sense of meaning.”[2] Developed in 1981, the MBI was the first instrument to measure burnout, and remains widely used today.
Are people in the helping professions more likely to experience burnout? According to recent surveys [3,4], burnout seems to be growing among workers across occupations, fueled by COVID-19 pandemic-related trends in working from home, remote schooling for children, and staffing shortages. But healthcare workers and educators have been hit the hardest, and even prior to the pandemic, these occupations have historically been most impacted by burnout. To understand why, we can examine the traits of people who are most vulnerable to burnout, but even more importantly, we need to look at the characteristics of jobs that burn people out.
Burnout doesn’t happen to slackers, but rather to those who are the most conscientious and hardest working, and who regard their work as a calling.[5] The traits of people who are most vulnerable to burnout include:
- Being a helper, by nature or occupation;
- Scoring high on conscientiousness and agreeableness (Big Five Personality test);
- Taking pride in one’s work ethic and dedication;
- When the going gets tough, they don’t quit, they just work harder; and
- They believe that asking for help is a sign of weakness.
Do any of those ring true for you?
Burnout is caused by chronic and excessive job-related stress, not by any deficiency in the individual. The characteristics of occupations that have highest rates of burnout include:
- Involving the provision of direct services to people in the areas of health, mental health, and primary education;
- Responsibilities are loosely or vaguely defined, additional responsibilities are constantly being added;
- Success is difficult to measure, there’s never an endpoint or goal post;
- Rewards are intangible, few, or fleeting;
- Job demands exceed what is humanly possible, given time and resource constraints.
Therefore, it is increasingly difficult to do the job well, or meet the needs of those you are supposed to serve. Does this sound like your job?
How do you know if you’re suffering from burnout? In my experience, these are the key signs:
- You’re more impatient or irritable than usual;
- You don’t feel well-rested after a night’s sleep;
- You’ve stopped doing activities that normally bring you pleasure or involve self-care;
- You find yourself saying or thinking more often, “I just don’t care” about your job; and
- You don’t feel ready to go back to work after your regular days off.
You may also find yourself getting more and more behind on routine work and household tasks, and thinking more often about quitting, changing jobs, or retirement.
A key point: burnout is not the same as depression. Because there is a significant overlap of symptoms, those who are suffering from burnout may believe, or may be told, that they’re clinically depressed, however, the causes of burnout are different, and so is the treatment. (Of course, it’s possible to have both burnout and clinical depression, in which case you will need to address both conditions.)
What is the treatment for burnout? Ideally, a signficant amount of time off work. For some people, a couple of weeks might be enough, for others, a month to a year may be needed. Of course, this is not possible or realistic for many people, so then you will need to implement these self-care tasks while continuing to work:
- Start with setting some boundaries. Learn to say “no,” or “not now,” and let go of any non-essential tasks;
- Ask for help from colleagues, or delegate if you can;
- Prioritize getting more sleep and exercise, eating healthier, and reaching out to family and friends for social connection;
- Change your attitude or approach to work. Become willing to be “good enough” rather than “great;” commit to leaving work on time, or if you work from home, create boundaries to separate work from home and family life;
- Take some time to review your life goals, and what gives you a sense of meaning and purpose. If it’s not your job anymore, then begin to explore other options.
- Finally, I highly recommend seeking out a psychotherapist to assist you in this process.
When I saw my client again, she seemed a bit happier, and reported that she had set some limits with the family members who had been most demanding of her time. She’d also resumed her exercise routine, was making plans for a trip with friends, and was actively looking for a job that was less direct-service oriented. And how did I address my own incipient burnout? I have decided to take a break from teaching mindfulness classes, even though I love doing so, to give myself more time for rest, relaxation, exercise, and visits with friends and family.
Notes:
1. Burnout an “occupational phenomenon”: International Classification of Diseases WHO. 28 May 2019. Referenced in Wikipedia page on occupational burnout.
2. Christina Maslach, quoted in Zuckerman, C (2021, April 30) How to Beat Burnout without Quitting Your Job. NYT online, retrieved March 28 2022.
3. Survey by Robert Half Int’l, referenced in Maurer, J. (2020, December 16) Remote Employees Are Working Longer Than Before. Retrieved from SHRM HR Today, online ed.
4. Threlkeld, K. (2021, March 11) Employee Burnout Report: Covid-19’s Impact and 3 Strategies to Curb It. Retrieved from Indeed.com.
5. From “The Exhaustion Funnel,” handout from my MBCT course.
Calming the Anxious Mind
We are living in turbulent times. If you are paying attention at all, it’s hard not to feel anxious about the state of the world we live in and the fate of humanity. While violence, war, and natural disasters have occurred throughout human history, we seem to be experiencing them today with a new level of intensity – from the effects of climate change to the rise in terrorist activity – while our leaders and politicians seem more concerned with their own approval ratings than providing actual leadership.
We also live in a “500-channel universe,” a world of seemingly infinite possibilities for distraction. Distraction is a common coping strategy against anxious thoughts or worries, but when we are bombarded by TV and radio programming that aims to offend and shock, advertising that urges us to spend money we don’t have in a never-ending quest for happiness, and the constant stream of bad news, our nervous system gets stressed, and may become overloaded.
The pace of daily life has sped up, to a speed that may actually exceed the brain’s ability to process and respond to our experience in an effective way. When I was growing up, we were promised that technology would make our lives easier, and give us more leisure time (remember “The Jetsons”?) Instead, we have less free time, with our cell phones, laptops, and tablets keeping us connected to the office and to everyone we know 24/7, even while we’re supposed to be sleeping or on vacation. This lack of down time adds to our stress and anxiety.
Anxiety and worry are normal human emotions, emanating from the part of our brain that houses our survival instincts. (Read what Rick Hanson, PhD says about the brain’s “negativity bias.”) Anxiety can be passed down in families, both as a genetic predisposition and as learned behavior. Everyone experiences anxiety at times, though some people are more sensitive to it, while others are anxious all the time. Anxiety is one of the most common reasons that people take medication (or use alcohol, drugs, or food to “numb out”). So what are some healthy ways to relieve anxiety, and calm the anxious mind?
One way is to “unplug”: see if you can turn off your devices when you’re eating and sleeping, and leave them at home while you enjoy a walk in nature. Stop watching the news on TV before bedtime, and read a book instead. Can you go for a whole day without checking email or texting? Finding ways to reduce the amount of stimulation to your brain may lower your anxiety level.
Another way is to challenge your assumptions and thoughts about whatever is making you anxious. If you’re prone to playing the “worst case scenario” game in your head, you may be scaring yourself, and making things worse than they actually are. The gold standard of anxiety treatment is Cognitive-Behavioral Therapy (CBT), which teaches you to change how you feel by changing your thoughts and behaviors. Check out this new CBT workbook: The Road to Calm
Because we experience anxiety in the physical body, as well as in our minds, Mindfulness-Based Cognitive Therapy (MBCT), a newer variation of CBT, incorporates meditation and yoga practices. As a CBT practitioner for over 25 years, and an MBCT practitioner for the last seven, I’ve found that mindfulness and meditation practice improve the efficacy of CBT, and are also stand-alone practices that can be very helpful to manage anxiety and relieve its effects.
At its most basic level, mindfulness invites us to wake up to the present moment, and notice that we’re breathing – “I’m awake and alive, right now.” While this might not strike you as a reason to rejoice, if you stop to think about it, that we breathe automatically is truly amazing. Mindfulness is about stepping out of autopilot mode, and using the breath and body to ground us in the present. However, if you’re experiencing anxiety, this can get dicey.
A typical mindfulness meditation practice is to focus on the breath. Many people find that this promotes relaxation and calmness, but if you are prone to anxiety, focusing on your breath can actually make you more anxious. You might notice that your breathing is kind of shallow, or a bit rapid, so you try to take a deep breath or slow your breathing down, but then the harder you try the more it seems to speed up, until it feels like you can’t breathe at all! Has that ever happened to you?
And did you then conclude “meditation is not for me?” The problem here is that bringing conscious awareness to automatic processes in the mind and body, while beneficial for most people, can backfire for anxious people, who are already hyper-focused on things that other people don’t even notice, like their breathing, heart rate, and worrisome thoughts. But if you give up on mindfulness and meditation so soon, you don’t give your mind and body a chance to reap the benefits, which are signficant. Herein lies the paradox of mindfulness.
Whether it’s your breath, or your life, if you start with wanting things to be different than they are, you create more stress and anxiety for yourself. Mindfulness invites you to just observe what is, without judgment or worry, and without needing things to be different. If you can do that, then change may come, often effortlessly. You might try this brief breath meditation:
Still not sure about meditation? Perhaps some mindful movement, like Yoga, Tai Chi, or Qi Gong, can help. One of my favorite forms of mindful movement is walking meditation, where we focus our attention on the sensations involved in walking, slowly and intentionally, just being present with our experience without needing to go anywhere. Walking this way, we find there’s actually a lot to notice, so we’re not just focused on the breath, and this, plus the gentle, rhythmic movements of our body, can help to calm the anxious mind. If you’d like to try walking meditation, here are some instructions:
A Ladder and a Map: Tools for Emotion Regulation
I recently had the opportunity, due to the pandemic, to attend a virtual version of an annual conference for psychotherapists that is usually held in Washington D.C. One of the webinars I attended, by Deb Dana, LCSW, offered some simple and practical tools to use with clients, based on a not-so-simple to explain theory, the Polyvagal Theory. The first tool is a ladder; the second, a map, or a series of maps.
Polyvagal Theory was developed by Dr Stephen Porges, and even though I’ve read his book and listened to several talks he’s given, I still have trouble clearly explaining it. In a nutshell, it merges evolutionary neurobiology with attachment theory to describe the mechanisms behind a hierarchy of human responses to perceived threats. These responses include one most of us are familiar with, the “Fight or Flight mechanism,” as well as a “Freeze” response. Porges’ theory helps us understand how emotional regulation is a function of interpersonal connection, how trauma disrupts those connections, and most importantly, how people can regain emotional equilibrium after being dysregulated by a threat or trauma.
Before I get to the ladder and the map, a little background. If you studied human anatomy in school, you learned that our autonomic nervous system (ANS) has two branches, the sympathetic (SNS) and the parasympathetic (PNS). The SNS governs movement, doing, while the PNS governs resting, being. The “fight or flight” response is generated by the SNS, while the PNS leads us to “rest and digest.” In a healthy functioning ANS, the two branches work in harmony. The sympathetic branch acts like the accelerator on a car, while the parasympathetic branch acts like the brake. Simple, right?
Here’s where it gets more complicated. The term polyvagal comes from the vagus nerve, which is a large nerve that connects the brain with the major organs of the body – lungs, heart, stomach – as well as the face, eyes and ears. The vagus nerve is like “command central” for the PNS. A key discovery of Porges was that there are two pathways of parasympathetic response, one of which causes the “freeze” response, when a person becomes immobilized in the face of a threat or trauma. The other pathway has an opposite response, leading to social engagement and connection. The immobilization response is a more primitive protective mechanism that all mammals have. The social engagement response is a more evolutionarily advanced mechanism, which only some mammals (dogs, cats, horses, elephants) and all humans have.
These two pathways are called Dorsal Vagal and Ventral Vagal. In the Dorsal Vagal response, the organism moves to shut down, in an attempt to save itself (think of how a mouse might feign death to escape from a cat, who loses interest when it stops moving). A person in this state may feel numb, disconnected, lost, abandoned, invisible, hopeless, and despairing. The Ventral Vagal response, in contrast, moves the organism to connect to self and others. A person in this state may feel alive, energized, tuned in, resourceful, flexible, and hopeful. Can you recall experiencing either, or both of these states?
The ladder is a visual representation of the range of responses to a perceived threat, from immobilization (Dorsal Vagal) at the bottom, to social engagement (Ventral Vagal) at the top, with the sympathetic responses that mobilize us (Fight or Flight) in the middle. The ladder is a tool that allows you to locate where your own response lies, to identify how dysregulated you are, and to see that it’s possible to climb out of immobilization into mobilization, and from there into engagement and connection. Most likely, you will need help to do this.
Polyvagal Theory recognizes that all of these responses are adaptive survival mechanisms that often operate below the level of conscious awareness. We don’t choose to fight, flee, or freeze, so there’s no reason to get down on ourselves when we do. The good news is that once we can come to understand what’s happening, we can learn how to move out of that automatic reaction into a more regulated state.
Connectedness is actually a biological imperative. People are inherently social beings, and our nature is to interact and form relationships with others. And it is within those interpersonal relationships that we learn to regulate our emotions. Think about how a baby cries when it is hungry, tired, or has a soiled diaper, and how its mother-caregiver offers comfort through a soothing voice, facial expression, and physical touch. These are instinctive responses that bring mother and child into “co-regulation” of their physical and emotional states, an equilibrium. As adults, we still want and need to experience co-regulation with others. When we do, we feel safe, at ease, relaxed, content. We can face challenges and function effectively in the world.
Trauma and other threats to our safety and well-being disrupt this natural drive to connect, and interfere with an individual’s ability to seek and experience co-regulation. The fight or flight responses, and especially the Dorsal Vagal collapse, are coping mechanisms designed to keep us alive, but they aren’t intended to be long-term modes of functioning. And they block us from establishing the connections we need to co-regulate and regain emotional equilibrium. The dilemma is, how can we engage and connect with others when we don’t feel safe?
This is where the map comes in. In Deb Dana’s process, therapist and client co-create a map or series of maps to first name and describe where the person may be on the ladder, and then identify the steps that will move them toward connection and social engagement. For example, if they are immobilized in a Dorsal Vagal collapse, the first steps may include establishing a sense of safety by doing grounding exercises, and to offer themselves some kind words of comfort and soothing gestures. The maps include both things the person can do on their own, and things they can do that involve others, for example, text a friend, accept a hug, or go for a walk in a park where there are other people around.
If you would like to learn more about the Polyvagal Theory, there are many YouTube videos with Stephen Porges, and a TED talk by his son Seth Porges. To learn more about Deb Dana’s approach to restoring emotional equilibrium, I recommend her new book, and podcast, “Befriending Your Nervous System.” And if you would like to work directly with a therapist to learn how you can use the ladder and maps for yourself, please contact me!
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Healing from the Trauma of Toxic Narcissism
I have been struggling to write something relevant to the current political and social turmoil that might be helpful; yet while I have many opinions, I am not an expert at political, economic, or social trends. But one thing I do know about is narcissism and its effects.
I know that narcissism exists on a spectrum, from charmingly self-absorbed to pathologically destructive, and I’ve known people who fall all along that spectrum. I’ve witnessed the effects of growing up with a narcissistic family member; I’ve been personally affected; and I’ve spent years in therapy healing from it. I’ve had several narcissistic bosses. And I’ve also had, not surprisingly, lots of clients who are dealing with the effects of a narcissist in their lives.
I have been triggered by the election of a pathological narcissist to the highest office in the land, and felt somewhat traumatized these past four years by his words and actions. I know many others have as well. Maybe that’s why I haven’t been able to write about it until now, now that he’s finally headed out the door. (Cue, “Hit the road, Jack, and don’t come back no more no more no more no more. . . .”)
Because of my experience, I have excellent radar for narcissists, and avoid them whenever possible. This one’s extreme narcissism seemed so glaringly obvious, I didn’t understand why people voted for him in the first place, and I’ve been at a loss to make sense of why so many voted for him again, after seeing four years of his total lack of empathy and concern for others, the self-aggrandizement, the grandiosity, the meanness, the lies, lies and more lies. His “purposeful, vindictive chaos,” as I heard Jon Stewart say on the Colbert Show in January 2017.
When you grow up with a narcissistic parent, your own sense of self doesn’t fully develop. You are more vulnerable to being manipulated by other narcissists, because you’ve been trained to seek affirmation through people-pleasing. You are more likely to be attracted to, and seek out relationships with, other narcissists. Or you may eventually become one. Unless, of course, you’re lucky enough to have some positive, nurturing adults in your life, and the opportunity to get therapy, and to find a support group.
The support group I found, quite by accident, was Adult Children of Alcoholics, a self-help group modeled after Alcoholics Anonymous. At my first meeting in 1982, I was completely blown away as I heard others sharing thoughts, feelings and experiences just like mine, which I had never told anyone. For the first time in my life, I felt I belonged. Which was very weird, because there were no active alcoholics in my family.
Turns out that narcissism is a key trait of alcoholism, and the two co-occur in families with great frequency. In fact, today the group is called Adult Children of Alcoholics/Dysfunctional Families. I also learned later that the effects of growing up with an alcoholic can be passed down over generations. But I didn’t need to know those things in order to know that I should keep going to ACOA meetings. What I learned there was tremendously helpful in healing my own wounds, and allowed me to become a healer for others.
When you grow up with an alcoholic parent, you are vulnerable to becoming addicted yourself, whether to alcohol, another substance, or compulsive behaviors like gambling and shopping. You’re also more likely to be attracted to, and seek out relationships with, other alcoholics or addicts. You may become a people-pleaser, or be terrified of abandonment. The most common traits of Adult Children of Alcoholics have been compiled by members, and called The Laundry List.
Back in the 1980’s, when I was learning about my own dysfunctional family dynamics, there was a popular PBS show hosted by a man named John Bradshaw, who talked about family dysfunction caused by alcoholism, and explained how the children in these families each take on different roles to protect themselves, or other family members, from the chaos, confusion, and fear that the alcoholic’s unpredictable rages and destructive behaviors cause. They may become super-responsible, taking over the parent’s role, or they become enablers or super-caregivers. They might fight back against the alcoholic’s raging, or they might try to become invisible and disappear.
Everyone in this country has been affected by the actions of the narcissist in the White House, but just like in alcoholic families, the effects are different for different people. Some people have taken heroic action to speak up and stand up to his bullying behavior, risking their jobs. Others have mirrored him, seeking his approval by striving to be just like him. Others have exhausted themselves trying to make everyone else happy. And some are simply lost, numb, mute. Those are the ones I’m most worried about.
When you don’t develop a healthy sense of self, you can’t take care of yourself. When your sense of self is distorted by narcissism, you can’t take care of others. The narcissistic parent only loves him/herself, and demands unconditional adoration while dispensing scorn and disdain. That is a traumatizing experience for a child. This country is now full of people who have been traumatized by the narcissist in the White House, directly or indirectly.
Rates of substance abuse and addiction are up, so are rates of anxiety, depression and suicide. The effects of trauma show up in other ways: emotional withdrawal or dysregulation, nightmares and insomnia, difficulties in interpersonal relationships, bullying behavior, lack of academic or career progress, or outright failure to navigate the stages of adulthood.
So now what? How do we begin to heal these wounds? We can start by recognizing what has happened to us, and calling it what it is: the Trauma of Toxic Narcissism. Trauma therapists know that the most important first step in healing trauma is to create a safe space for trauma survivors to process what’s happened. Even when the toxic terrorizer has been vanquished, people still may not feel safe. (I know people who didn’t feel safe even after their narcissistic bully was dead.) Bessel van der Kolk, author of The Body Keeps the Score, has some wonderful videos and resources on Healing from Trauma, and Lisa Najavits has excellent books and trainings on Seeking Safety originally developed for women with PTSD and addiction.
We also need to take immediate and strong action to stop the proliferation of toxic ideas and behaviors that the narcissist has spawned, stopping these Mini-Me’s in their tracks so they can no longer intimidate others. The United Nations has published guidance on countering COVID-19 hate speech, which builds on their global plan to counteract hate speech and contains recommendations for business leaders and individuals. This might be a starting point.
I wish everyone would learn what I have known for years: the narcissist doesn’t change. He doesn’t listen to feedback, he doesn’t learn from his mistakes, he doesn’t acquire wisdom, and he is incapable of developing compassion. He only becomes more of what he is: vain, selfish, mean, delusional. But WE can change, and that’s what truly matters.
Above image created by Freepik – www.freepik.com
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