As a therapist with a focus on nervous system regulation and trauma, I work extensively with healthcare workers, providing therapy for physicians, hospitalists, surgeons, nurses, fellow therapists, and emergency responders in the Los Angeles and Pasadena area. These populations come into therapy with unique challenges that are often not fully understood by the general population or mental health teams.

SYSTEMS OF SELF-NEGLECT

The reality is that the modern healthcare system doesn’t prioritize the mental health and well-being of its workforce. The level of requirements, sacrifice, and training needed to enter certain specializations in healthcare is immense and can take a huge toll on mental and physical health over time. For instance, the journey to becoming a specialized attending or surgeon requires a level of consistent, unwavering excellence. It may be difficult for civilians and therapists who do not consistently treat healthcare workers of this nature to fully empathize with the sheer amount of personal sacrifices required by the field itself. These demanding career paths take a toll on physical and mental health, often requiring professionals to compartmentalize emotions, expend high levels of social energy, sacrifice relationships with family and friends, manage looming emergencies, and maintain a low-grade state of hypervigilance to meet the demands of their critical roles.

STIGMA AROUND MENTAL HEALTH

Healthcare workers often approach therapy with a unique and understandable level of skepticism and hesitation due to the fundamental differences between mental health and the medical field. The tangible nature of medical science, quantifiable outcomes, and rigorous research standards contrast with the subjective and less concrete nature of mental health. This contrast can lead to higher levels of skepticism among healthcare professionals when it comes to therapy. Additionally, the stigma within the healthcare system itself, where seeking help is often seen as a sign of weakness or inability to cope, can further complicate the process of seeking therapy for these dedicated helpers.

VICARIOUS TRAUMA

Healthcare workers often experience vicarious trauma by witnessing or being part of challenging and distressing situations. Even when they are acclimated and “used to” these situations and learn to compartmentalize/ dissociate from reactions to these events, their bodies are often in high states of sympathetic nervous system activation. Over time, these cumulative stressors can impact their physical and mental health.

DISSOCIATION VIA OVER-INTELLECTUALIZATION

Numerous healthcare workers possess exceptional intelligence and understanding of their issues and challenges. Many of these clients enter therapy with well-structured conceptualizations of their problems. However, despite their wealth of knowledge, they often continue to struggle with the issues. Moreover, to excel in the healthcare field, many professionals have learned to dissociate from their bodies and compartmentalize their emotions as essential survival skills for their demanding roles. These skills are crucial in their work, but without a balanced approach outside of the workplace, coupled with intentional nervous system regulation strategies and emotional processing, they can lead to a significant imbalance.

RELATIONAL PROBLEMS

The massive personal sacrifices required in many sectors of healthcare impacts relationships. The dedication to patient care and the high-stress nature of the work can often lead to strained personal relationships with family, friends, children, and partners. Balancing long hours, on-call shifts, service blocks, and the emotional toll of their responsibilities can impact their ability to connect with loved ones. Furthermore, the need to compartmentalize emotions while on the job can make it challenging to switch gears and be fully present in their personal lives.