“Perhaps the biggest tragedy of our lives is that freedom is possible, yet we can pass our years trapped in the same old patterns… We may want to love other people without holding back, to feel authentic, to breathe in the beauty around us, to dance and sing. Yet each day we listen to inner voices that keep our life small.”
― Tara Brach
Most people experience distressing things as part of being human. We try to recover from these encounters as best we can, and usually are able to do that. We get through incredibly difficult situations often by doing what we need to do: feeling the emotions appropriate to the situation, talking to a trusted person in our life, or otherwise engaging in our own process through which we move through and make sense of that experience— often toward full resolution. The result is we can talk about that experience with the expected and appropriate amount of emotion and activation, which is unique to the individual and experience.
Sometimes, despite our best efforts, an experience is so overwhelming or unexpected that we cannot use our typical process(es) to reach resolution, or perhaps something impedes our process. When this happens, we may feel emotionally or physically activated by thoughts or reminders of the event, and might start to avoid things that remind us of the event in order to not feel that activation. With avoidance may come a sense of isolation, anxiety, or depression; feeling alone and like others may not understand. Sometimes people develop negative beliefs about themselves or others, depending on the circumstance. Perhaps a belief that this event should not impact them the way it has, or it was their fault that this event happened. Conversely, the belief that another person is to blame in some way, yet the person is powerless to do anything about it.
For emergency medicine professionals in particular, the repeated and consistent exposure to traumatic events and death, instances of moral injury and ethical constraints, verbal aggression and/or threats of violence, and the physical and mental toll that comes from working in a high-stress, fast-paced environment can negatively impact someone over time. They sometimes feel confused about why they begin to dislike a job they used to enjoy, feel cynical, ineffective, and fatigued. People often say “I knew what I was getting into” or “it’s just part of the job,” though it’s unlikely that the full weight of residency, group metrics, consultant calls, and Press Ganey scores was fully understood at the time. Does anyone entering these types of jobs know in advance the feeling of isolation that comes when you feel like you can’t talk to your family about the difficult day you had at work?
We will begin with an intake assessment to take a history of your life, presenting concerns, and goals for therapy. The first several sessions will be spent getting to know one another, and deciding if we are a good fit. Some signs of a good fit include: feeling heard, respected, beginning to feel like you might be able to trust me/ this therapeutic relationship over time, feeling emotionally safe, feeling like I’m actively trying to understand your experience. We will collaboratively develop treatment plan goals based on what you’d like to achieve during our time together. We will work together over time, utilizing whatever modalities or techniques that are suited to you, in an effort to achieve your goals. We will regularly review your progress to ensure we are making the most of our time together.