Guest Post by Rachel Swanick: “Is it time to finish, yet?”

“Is it time to finish yet?”, Malachi* shouted at me for what felt like the hundredth time that session. “Yes”, I replied wearily, “it is..”. I was tired; tired of many things that day. I was eight sessions in to my six months work with Malachi and we had so far spent most sessions battling through rejection, meanness, and chaos. After I tidied up the music therapy space, I got back in my car to head off to another couple of sessions before picking up my own children. I checked my phone and there were four missed calls and umpteen emails that needed my attention… by the time I had returned home, I had had enough. I had run out of energy and was starting to feel physically ill.

The next day, I went to the doctor. I had been very ill in the night with stomach pains and the thought of work was too much for me. My doctor listened kindly as I explained my physical ailments before quietly saying, “and how do you really feel?”. I broke down. In my work as a Music Therapist, I spend a lot of time looking after the well-being of others; not only my clients but the many therapists that I line manage or supervise. When clients or therapists come to me in need, I always ask them, “and what about you -w hat are you going to do today that will help you?”. Many arts therapists (and perhaps other types of workers, too) are freelance or associates, usually working remotely from their head office or team. We manage our time alone, spending many hours in the car driving to work, fielding calls and emails as we go about our lives, managing late calls from families and social workers in crisis during our own family time. There are of course positives to this: we are masters of our domains and in control of the work we chose, with plenty of autonomy to boot. The downsides are that our relationships are with the end of a phone, and we can feel alone as we carry the weight of our client expectations as a heavy burden. The sense of well-being and resilience we are trying to instill in our work is lost to us as we manage difficult emotions, safeguarding issues and vast lists of admin duties. As Malachi shouted at me, “it is time to finish yet?”, how many times have we wanted to say that ourselves?

So, there I was on sick leave, being still on the couch, watching the birds busily flutter around the garden. I reflected over the past year in the hope of making sense of my feelings but even thinking felt like hard work. After a week or so, I met with a friend. She described feeling similar to me a few years ago. “Yeah, I remember when I was burned out, I had…”. I stopped listening to her once she said Burned Out. That was it! That was the feeling. I tuned back in to my friend, “… so I took some time out and realised things had to change”.

As therapists, we spend plenty of time thinking about the worlds of others but maybe not enough time on ourselves. I hadn’t been able to think about my own needs in the wake of managing the needs of others. And there was more ‘stuff’ lurking underneath this. I couldn’t admit to feeling burned out as then I would have failed. I consider myself very lucky having the job that I do. Every day I get to play music, be creative and help people. When I hear the woes of other people, I am thankful for all that I have. The truth is, though, that carrying the needs of others – whether that be for work or your family – is exhausting. Hearing other people’s problems, managing admin, looking after your family, travelling lots, and, for us music therapists, CARRYING ALL OF THOSE INSTRUMENTS (!) literally weighs us down. Being continually self motivated to complete the bread and butter work whilst trying to seek ways to develop oneself is a hard thing to maintain and, sometimes, something has to give.

In this article, I thought about trying to link these difficult feelings to a client case study. However, I felt it would be more appropriate speak to other therapists; who else has felt like this in the past? Are you feeling like this now? What advice can you give other therapists? Quite a few different types of therapists answered my plea on social media. Their responses were similar in many ways. Each had not noticed that they were becoming unwell. Work pressures had built up, leaving them in a state of hypervigilance and high anxiety. This state of mind was a prolonged state, often staying with the therapist for weeks or months. Reading through the stories, there are underlying themes of powerlessness, not being heard and not feeling supported by those professionals around them.

The therapists who responded to me used many metaphors to describe these experiences. There were mountains to climb and journeys to travel upon. Many seemed positive about what happened, with one stating that “it was the best thing that has happened to me”. Feeling burned out, with nothing to lose, helped the therapists to re-evaluate what was important in their lives. Change happened and new opportunities came. Hope blossomed.

When I asked the therapists what they thought was important to help others to maintain a sense of well-being, each one stressed the importance of consistent clinical supervision, clear lines of management and a need to feel invested in by their employers and colleagues. Some therapists do not understand the importance of having personal therapy or clinical supervision until it is too late. Furthermore, employers should have a responsibility to ensure good enough and frequent supervision is available to all therapists, no matter what field they are working in (interestingly, I have lots of support at work and regular supervision). And Music Therapists, how do we encourage creativity in building resilience in the work place? There is enough emphasis on talking and policies but surely the currency that makes us so unique – being creative – should be more available to us, too.

By writing this article I am not promising answers to the feelings (if you do have some, send them on a postcard?!). I am hoping that by saying this out loud, that others will find a space for themselves to think about their own wellness at work (always the therapist!). In our culture presently, there is emphasis on taking control of your well-being. You could try journaling or jogging, mediation or mindfulness, take a hot bath or take a trip round the world, change your diet or change your hairstyle…. Anything where you can be in charge of your destiny. Perhaps being burned out is about being out of control. I am going to sit with the uncertainty of these feelings. I have made some small changes and I know I have hope because I keep trying. I can see where I would like to be but I can’t see the path. In a more positive mood, I might say that I need some sunshine to illuminate the way or that there needs to be a good old storm to get rid of the mess. Or maybe, I will sit here and watch the birds for a while….. Violins: tacet.

Special thanks to all those who helped and inspired this article.

*All names have been changed to protect identities.

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Rachel Swanick Written by:

Rachel Swanick is the Senior Clinical Therapist for Chroma in the U.K. and specialises in psychodynamic music therapy for attachment, trauma and wellbeing. Rachel's work encompasses clinical work and assessments with children and families, the supervision of therapists, as well as presenting and writing about music therapy. Rachel is an Artist in Residence for the Manchester Museum and Whitworth Art Gallery where she leads the multifacited arts and wellbeing project, Here and Now, and a Social Prescribing programme for families. Rachel plays violin and piano, performing regularly.

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