ACTing Against Burnout: Final Steps

ACT interoceptive exposure

Key Points

  1. Using ACT helps clients to create space from their burnout and bring attention to meaningful behaviors, rather than focusing rigidly on overwhelming thoughts, emotions, and sensations.
  2. Making progress requires small, incremental steps of engagement and being present in moment-to-moment experience.
  3. Utilizing metaphors, such as names, characters, and animals, helps to make abstract concepts like burnout or the mind more tangible yet usefully distanced for both client and therapist.
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Practicing Curiosity

Once clients are able to notice patterns in the moment, they need the skills to make different decisions in response. Jack had a lot of fused content around physical sensations like fatigue in addition to thoughts. He was asked to describe what exhaustion felt like. At first he said he was exhausted, couldn’t do anything, wanted to go to sleep.

Those were thoughts, so more questions were needed to get to feelings. Did he feel exhaustion in his face? Yes, his eyelids were really heavy. Could he practice opening his eyes? His eyes were open, it just felt harder. So he noticed the distinction between having a feeling and still being able to do a behavior. He noticed cramping in his back from sitting at a desk all day. Did that feel like aching, pulsing, or piercing? Getting him to lean into curiosity about those sensations and describe them created space from them, because he had to pause and pay attention in the moment.

Defusion exercises don’t make thoughts and sensations go away. They take them from being all-consuming and blocking experience to being just another part of the here and now. We’re still aware of them, but they’re in our periphery and we’re better able to look up and engage with the rest of the world and our lives.

Clients experiencing burnout can feel apathetic, exhausted, fatigued, and irritable. They may also feel anger if their burnout was caused by co-workers or systemic issues of ethics or unfairness in their workplaces. Connecting to and describing feelings and sensations not only creates defusion, but also draws in values, by attaching decisions or behaviors more consciously to what’s important to clients in the moment.

Defusion and Values

Jack was supposed to finish work at seven because he was going to have dinner with his wife. Then a phone call came in, he looked down, and he noticed it. He felt that usual intensity about having to answer the phone. He thought to himself, okay, I’m noticing that. I’m also noticing that I made this commitment to my wife. I’m remembering that I haven’t answered the phone before this and the world didn’t actually end.

Once we get a little space from something, we can make different decisions. These movements are small: 30 seconds of focus, describing something in a sentence or two, closing a laptop. We’re not talking about starting a new career, running away to a farm, or shouting at our boss. Just small steps that create pockets of energy, space, and time which, added together, give clients some traction.

People feel very stuck when they’re burnt out. ACT is the difference between running a mile then falling down or picking your foot up and taking one step then another. Because that is how progress is usually made over time. Even if someone makes a radical shift like quitting their job or making a career pivot, it’s small steps that lead up to it.

Naming the Mind

As noted, language choice plays an important role in defusing from thoughts, creating the habit of saying, “My mind is telling me,” rather than, “I think”. We can take this a step further by giving the mind a name and a character. When clients give their minds human or made-up names that are sassy or grumpy, it gives them space to say something like, “Oh, that’s just Frank, he’s in a bad mood right now,” in response to thoughts, and go about their day.

With clients who are good at visualization, you could ask them to imagine their burnout as an animal or other creature that’s following them around. Jack said it was an anxious mouse that kept crawling up his legs and whispering in his ear, saying all the things he should be doing and that he was behind. He named it Sprinkles.

Clients might initially give a little pushback, and that’s okay, because let’s acknowledge that it’s a weird exercise. But it gives you something separate from the client, a metaphor, to ask about in every session. If Jack talked about struggling to set boundaries or make changes, you could ask what Sprinkles was saying or doing. It gives a tangible feeling to abstract ideas like the mind or burnout. Not all clients connect with this, but even just saying, “Oh, that’s my mind,” or, “That’s burnout talking,” can be really useful. The mind is saying “no” but the body can do it anyway.

Jack’s Therapy: Conclusions

Today, Jack has really clear boundaries at work. He finishes every night by seven, and works no more than 12 hours a day. For some people, that might seem like a long day, but he still works a lot because he’s a CEO. He makes dinner with his wife in the evenings, and they go out to a movie at least once every other week. He spends a few hours volunteering at weekends. He takes breaks during his workday to do stretches and goes to physical therapy.

His life and work haven’t stopped being stressful. That’s a context he doesn’t really get to choose, but the way he approaches experiences allows him to continue with his work while putting effort and energy into things outside of work that are important to him. And he no longer sees himself as a CEO and nothing more. He’s Jack, and he works at a company in the role of CEO. There’s a crucial distinction there, and great progression.

Even if someone hasn’t reached the point where they’re experiencing an adjustment disorder or depressive episode, there’s still a lot of great work you can do with them. You can use the ACT framework to help them be present; connect with what matters to them; recognize what contexts, thoughts, feelings, and self-imposed rules aren’t working for them and are holding them back; and make changes toward living a life they truly want to live.

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ACTing Against Burnout: Final Steps