Rising from the Ashes of Professional Burnout

Recognizing the signs of burnout, and what you can do about it if you have symptoms.

By Clare La Plante, November 13, 2013

Six years ago, Alameda, California-based massage therapist Jennifer Hathaway, 50, was working parttime at a local spa where she needed to take as many massage clients that came through the door. One day, eight people showed up.
 
Hathaway performed the massages, but woke up the next morning feeling awful. “I called it a ‘massage hangover,’” she says. She asked herself this question: How many massages can I do in a day and feel normal the next day? “There is a point of burnout if you don’t understand your capacity,” she says. Eventually, she decided that she could only work half days.
 
Hathaway was correct in thinking overscheduling herself put her at risk for burnout. According to Michael Leiter, PhD, co-author of Banishing Burnout: Six strategies for improving your relationships with work, “Burnout has three elements. The most immediate is a fatigue you cannot overcome.” For example, you feel tired when you wake up in the morning and can’t recover your energy.
 
The second element is diminishing joy. “As the energy goes, your capacity for involvement tends to go,” he says. Finally, you lose confidence—and your sense of being effective. “You stop saying to yourself, ‘I’m good at this, and this is a worthwhile way to spend life,’” Leiter adds.
 
A lack of recovery time is a huge risk. Other risks include physical stress, such as the physical exertion of massage therapy, or injury. Dysfunctional work relationships play a part too. Those who work contrary to their values are at a high risk as well. A feeling you lack control or have limited growth opportunities, along with financial stress, can also lead you down the road of burnout. Ironically, says David Ballard, PsyD, Assistant Executive Director for Organizational Excellence at the American Psychological Association, those who are most motivated and dedicated—and whose job is a big part of their identity—are more vulnerable to burnout.
 
The truth is, as a massage therapist, you are in a profession where the risk for burnout is relatively high, which means you need to be extra vigilant about self-care. Don’t worry, though, with a little knowledge, awareness and fine-tuning, you can create an arsenal of physical, emotional, mental and financial strategies to help keep burnout at bay.

5 Burnout Basics for Massage Therapists

1. Understand your physical limits.

First, you have to work within your physical limits. According to a 2012 University of Pennsylvania School of Nursing study, nurses who worked 10 hours—or longer shifts—had two and a half times greater burnout. Strangely, however, these nurses had no idea they were heading toward burnout, actually reporting being happy with their flexible schedules. So, be sure to track your energy level so you have a good idea when you’re feeling most tired, irritable or ineffectual, for example, and adjust your schedule accordingly.

2. Pay attention to your body.

“It’s the advice you consistently get. Head over shoulders, shoulders over hips, hips over knees, keeping wrists straight,” says Rick Goggins, ergonomist and massage therapist. However, Goggins says you are more likely to be injured from overuse and repetition, which usually affects lower back, shoulders and thumbs. To combat this possibility, think about regularly switching from fine precision to larger body work, and try not to hold a static position or only use your hands.
 
Mastering several bodywork techniques—Goggins recommends three to five—can help protect your body from burnout and may also help you attract a wider range of clients. Take care of injuries when they first appear, no matter how mild the symptoms since early treatments tend to be both conservative and effective.
 
Listen to your own body, no matter what others are telling you. “Our bodies send us messages: ‘Take a break, get exercise, or get rest,’ but we have disconnected that mindbody connection. Our mind says, ‘Keep going, keep going,’” says Sheila Patel, MD, medical director of the Chopra Center in Carlsbad, California. In short, we are ignoring the very signs we should be heeding.
 
The thing is, says Ballard, stress isn’t the problem. We’re built to deal with stress, but not in a relentlessly “fight-or-flight” way. “We’re functioning more and more in this state of fight or flight, rather than our baseline of normalcy, of calm. It’s this ongoing high level of stress that causes burnout,” says Ballard.
 
Patel says one way to increase your capacity to tune into your body is through incorporating a daily mind-body practice, such as meditation. Research confirms its restorative effects, as well as its capacity to increase focus and empathy. She also recommends a daily mindful movement practice, such as yoga, Chi Gong or a walk outside.
 
Proper nutrition is important, too, she says. And the biggie: sleep. According to Goggins, “[Lack of sleep] has the same detrimental effect as working odd or long hours.”

3. Let it go.

The ability to leave work at work is also an important part of combatting burnout. If you can’t walk out of your office or work environment without continuing to think about work, your clients, tomorrow’s schedule or troubleshooting that tough spot for that one client, for example, than you are a prime candidate for burnout.
 
“Detachment means both activity and thinking,” Ballard says. Turn off your phone. Stop checking work emails. Set limits on how you will interact with work after work hours, and let your clients know so you can manage their expectations. Decide how often and when you will check messages, because doing so will give you a sense of control, Ballard explains.

4. Figuring your finances.

This control is important in many areas. “Burnout often happens when you feel helpless, as though something bigger than yourself is in control,” says Manisha Thakor, CFA, founder and CEO of MoneyZen Wealth Management. “When you have a savings cushion, you feel stronger.” If you don’t feel well, for example, you can take a few days off.
 
But many of us put finances on the back burner, which causes more stress. Thakor says the first step is to just decide that you’re going to deal with your finances. Next, aim to live within your means—no matter how limited. Living outside of your means affects your stress levels, and studies show that worrying about money can affect your decision-making capacities.
 
Be sure, too, that you protect your credit score by aggressively paying off your debt. For example, if you have debt up to $5,000, increase your minimum payment by $50 a month on your highest interest rate account. For amounts more than $5,000, increase your minimal payment by $100 a month. (Depending on the interest rate, says Thakor, you should be able to pay off your debt in three to five years.) Set up as many automatic bill payments as you can. Then, keep your business and personal expenses separate. Even a simple thing like having two separate checking accounts will work.
 
Thakor says we all need to look at our expectations. “It’s so easy to think if you had more money it would solve everything. But it is joy, happiness, and love that solve things,” she says. If you’re in a financial rut, the truth is that you can earn more, spend less, or both. And, when possible, it’s best to do both. “Maybe it’s taking on two more clients a week, and eating out one less time a week,” she says. To help, try what Thakor calls “joy-based” budgeting. Write down everything you spend in a week. At the end of the week, highlight the purchases that brought you joy—and eliminate what you did not highlight.
 
Finally, heed what she calls the three most powerful words in personal finance: Start saving now. Even if you start with just $5 or $10 a week, make putting some amount of money away each week a habit. Think of it as another mind-body practice. “You’re developing that muscle,” she says.
 
Thakor also encourages therapists to seek out a mentor. Ask your mentor how he or she manages cash. For example, how much money do they set aside for supplies, for example, or marketing efforts? What are their policies for clients who cancel, don’t pay or bounce checks?
 
Finding someone you can share both your challenges and successes with can prove beneficial, and also help you protect yourself against burnout. “Most people need community, a sense of belonging,” Leiter says. You need a way to process your day, your work. This may be a particular struggle for those in caring professions, he says, when you are often the one in whom everyone else confides. Take time for reflection during the day. Talk to colleagues. Even writing in a journal can help.

5. Be kind to yourself.

Finally, practice being kind to yourself. According to Christopher Germer, PhD, author of The Mindful Path to Self-Compassion, all the self-care practices are important and necessary. However, when you are dealing with burnout, or what he calls compassion fatigue, there’s a bigger question that needs to be considered: “How can we energize ourselves— or remain energetic, interested and vital—while doing the work?”
 
For no matter how many breaks we take, or how well we take care of ourselves, if we are not able to care for ourselves in the moment of the work, we may never break the exhaustion cycle. The key, he says, is to try to stay present with everything that comes up during the day. “The less we resist, the less we suffer,” he says. For example, if a client cancels at the last minute or a colleague says something rude to you, can you say to yourself: “This hurts.” Then, instead of using defensive strategies, like telling yourself that you never liked that client or colleague anyway, try being kind to yourself. Take a brief walk if you can, for example, or sit quietly with yourself for 15 minutes. If you have the time, call a friend. The point is this: Learn to take care of yourself so you don’t get overwhelmed by both the little and big occurrences that will always be a part of both your personal and professional life.
 
Self-compassion not only has mental and emotional benefits, but behavioral as well. “You are more likely to step away in a timely fashion,” Germer says. You will feel when you are getting run down. You will feel when you are starting to edge closer to burnout and fatigue. The difference? You’ll also know that you can, essentially, recharge your own batteries.
 
A second step is equanimity. “This is where you understand that each person is on his or her own life journey,” Germer says. For example, if you have a client with lower back pain and the massage you provide doesn’t relieve the problem, does it mean that you failed or were ineffectual? “No,” he says. “The pain may have a deeper cause. We may wish that we can eliminate problems, but sometimes we can’t.”
 
Most of us, says Germer, are actually nicer to others than to ourselves. When we accompany ourselves with great love throughout the day—whether things go well, or don’t go well—we will start to see the benefits. This self-kindness can translate into all sorts of good things for ourselves, including a resiliency that helps to burnout-proof a career. “The heart first needs to pump blood to itself,” he says.