Skip to main content

Listening to Trauma, and Caring for the Caregiver: A Psychodynamic Reflection in the Age of Burnout

  • Chapter
  • First Online:
Veteran Psychiatry in the US
  • 435 Accesses

Abstract

In this chapter, the author presents contemporary ideas from the medical literature regarding “burnout” in physicians and psychiatrists. He then describes what uniquely puts psychiatrists at risk for “burnout,” such as how psychiatrists must necessarily be affected while empathizing with patients and the ever-important therapeutic alliance. He next describes how the dynamics of healthcare systems and clinics, especially medical leaders, respond to the unique challenges of psychiatric practice, which may serve to support or undermine the doctor–patient relationship and alliance. Finally, he gives recommendations to enhance psychiatrist resilience, promote healthy organizational dynamics, and ultimately take better care of the patient.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

eBook
USD 16.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 89.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. American Psychiatric Association (APA). Well being and burnout. Retrieved from https://www.psychiatry.org/psychiatrists/practice/well-being-and-burnout 11 Mar 2018.

  2. APA, Psych News. Professional News. Active engagement in apa called remedy to burnout. Mark Moran. Published online: July 28, 2017.

    Google Scholar 

  3. Bateman A, Fonagy P. Mentalization-based treatment. Psychoanal Inq. 2013;33(6):595–613.

    Article  Google Scholar 

  4. Benjamin J. Beyond doer and done to: an intersubjective view of thirdness. Psychoanal Q. 2004;73(1):5–46.

    Article  Google Scholar 

  5. Bion WR. Experiences in groups and other papers. London: Tavistock; 1961.

    Google Scholar 

  6. Bion WR. Elements of psycho-analysis. London: Heinemann; 1963. p. 1–104.

    Book  Google Scholar 

  7. Carr RB. Two war-torn soldiers: combat-related trauma through an intersubjective lens. Am J Psychother. 2013;67(2):109–33.

    Article  Google Scholar 

  8. Delgado SV, Strawn JR, Pedapati EV. Contemporary psychodynamic psychotherapy for children and adolescents: integrating intersubjectivity and neuroscience. Berlin/Heidelberg: Springer; 2015.

    Book  Google Scholar 

  9. Demerouti E, Bakker AB. Version September 25, 2007. The Oldenburg Burnout Inventory: A good alternative to measure burnout (and engagement). Retrieved from https://www.researchgate.net/publication/46704152_The_Oldenburg_Burnout_Inventory_A_good_alternative_to_measure_burnout_and_engagement 23 Mar 2018.

  10. Freud S. Remembering, repeating and working-through (Further recommendations on the technique of psycho-analysis II). In: The Standard Edition of the Complete Psychological Works of Sigmund Freud, Volume XII (1911–1913): The Case of Schreber, Papers on Technique and Other Works. London: The Hogarth Press and the Institute of Psycho-Analysis; 1914. p. 145–56.

    Google Scholar 

  11. Hirshhorn L. The workplace within: psychodynamics of organizational life. Cambridge, MA: MIT Press; 1988.

    Book  Google Scholar 

  12. Hoge CW. Intervention for war-related posttraumatic stress disorder: meeting veterans where they are. JAMA. 2011;306(5):549.

    Article  CAS  Google Scholar 

  13. Joseph R. Doctors, revolt! New York Times. 2018:SR12.

    Google Scholar 

  14. Lictenberg J, Lachmann F, Fosshage J, editors. Narrative and meaning: the foundation of mind, creativity, and the psychoanalytic dialogue. London/New York: Routledge; 2017.

    Google Scholar 

  15. Mintz D, Belnap B. A view from Riggs: treatment resistance and patient authority—III. what is psychodynamic psychopharmacology? An approach to pharmacologic treatment resistance. J Am Acad Psychoanal Dyn Psychiatry. 2006;34(4):581–601.

    Article  Google Scholar 

  16. National Academy of Medicine. Clinician well being: factors affecting clinician well-being and resilience. Retrieved from http://nam.edu/clinicianwellbeing/about/ 23 Mar 2018.

  17. Shanafelt TD, Hasan O, Dyrbye LN, Sinsky C, Satele D, Sloan J, West CP. Changes in burnout and satisfaction with work-life balance in physicians and the general US working population between 2011 and 2014. Mayo Clin Proc. 2015. https://doi.org/10.1016/j.mayocp.2015.08.023.

  18. Slavin MO, Kriegman D. Why the analyst needs to change: toward a theory of conflict, negotiation, and mutual influence in the therapeutic process. Psychoanal Dialogues. 1998;8(2):247–84.

    Article  Google Scholar 

  19. Ullman C. Bearing witness: across the barriers in society and in the clinic. Psychoanal Dialogues. 2006;16(2):181–98.

    Google Scholar 

  20. Wise JE. Psychoanalytic approaches to treatment-resistant combat PTSD. In: Ritchie EC, editor. Soldiers and veterans case book. Switzerland: Springer; 2015.

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2019 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Wise, J.E. (2019). Listening to Trauma, and Caring for the Caregiver: A Psychodynamic Reflection in the Age of Burnout. In: Ritchie, E., Llorente, M. (eds) Veteran Psychiatry in the US. Springer, Cham. https://doi.org/10.1007/978-3-030-05384-0_21

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-05384-0_21

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-05383-3

  • Online ISBN: 978-3-030-05384-0

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics