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Episode snapshot

After nearly two years of talking with hundreds of therapists about burnout (and living my own), I’m revisiting the core question: What is therapist burnout—really? I share a body-based story from a back injury, then map burnout using a memorable lasagna metaphor so you can name what you’re feeling and choose a first small step.

You’ll hear about:

• Why the ICD-11 frame only scratches the surface for clinicians
• Why vacations alone don’t fix therapist burnout
• The layered experience of exhaustion, resentment, “I don’t care,” clinical grief, vicarious trauma, moral injury, body symptoms, and shame
• Small moves to create safety and margin before “doing the trauma work” on yourself

The Lasagna Layers of Therapist Burnout (because therapists need a good metaphor)

1. Noodles: Exhaustion as the base You’re doing too much. First step: do less. Fewer clients, fewer tasks, more margin.
2. Sauce: Anger and resentment Irritability that leaks into everything. Paperwork, payers, tough sessions, home life.
3. Cheese through everything: “I don’t care” Scary to admit. Often a nervous system survival response, not a character flaw.
4. Hidden filling: Clinical grief Losses without ritual or witnessing. Client death, sudden endings, ghosting.
5. Spicy layer: Vicarious trauma Intrusions, hypervigilance, worldview shifts from the work itself.
6. Bitter bite: Moral injury When systems force choices that betray your values. It hits identity and ethics.
7. Burnt edges: Body symptoms Headaches, GI issues, tight chest, sleep disruption—your body waving a red flag.
8. Top layer: Shame The whisper that says “You’re a bad therapist.” It seals the whole dish and keeps you stuck.

A body-based reframe

Like my back flare, burnout involves multiple systems at once. It’s not about you “mismanaging stress.” It’s about adjusting inputs, removing aggravators, and rebuilding capacity step by step.

Try one small move this week

• Create margin: Remove one task or one client block.
• Add safety: Choose one nervous-system support (sleep, movement, gentle connection).
• Get care: Loop in your therapist, PCP, or a trusted peer for assessment and support.

Related episode

• Ep. 70: Burnout doesn’t stay at work — how it spills into life and what to do next.

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