Given what we are facing as a nation, where we encounter losses at every turn, celebrating the wins in our work is all the more important. We need to be able to connect with every victory, no matter how small, to find some counterbalance to the fear and unknowns. This is equally important for our clients as it is for ourselves.

“Cheerleading,” as I call it, is a huge part of my approach to care. Our clients often aren’t able to see the subtle changes they are making because they are still in pain and focused on how far they want to go. I view it as my job to point out and celebrate every baby step. This both communicates that I am paying attention and it reinforces the changes themselves. It also helps my sustainability.

Ironically, fully internalizing and benefiting from those wins, including the biggest win of all, a client completing therapy, is something I struggle with, even before the chaos of recent months.

Why is it so Hard to Celebrate the Wins?

Don’t get me wrong, my cheerleading is genuine. I am happy and proud to see my client’s hard-fought efforts come to fruition. I am amazed by how far people can come in their healing journeys. And I struggle to feel sufficiently buoyed by the wins to balance out the heaviness and weight of this work.

This is something I want to work on. I want to practice what I preach, since I’m always advocating for celebrating the wins. I promote this because I think it is essential for mitigating burnout and compassion fatigue. While I see all these benefits, I also understand why it is hard for me, and others, to do. Which is what I’m going to talk about today.

Time and Experience

One of the blocks stems from the impact of time and experience. Including training, I have been doing therapy for 14 years. I no longer feel the “oh wow, I can do this! I am capable of helping someone! This is incredible!” glee of early training. I am also no longer “wowed” by the power of a subtle intervention. And I no longer surprise myself (or impress myself, if I’m being honest) when I can sort through a complex web to identify what is happening in the moment and how it ties back to seminal events and core beliefs, while honoring what is being activated in me (ALL AT THE SAME TIME!!).

Where I once felt overwhelmed by the complexity of an individual, I now feel the cumulative weight of how much we can hurt one another, in subtle and horrific ways. I feel more rage for how systems and cultural norms fail us and fail children, so that patterns of abuse are perpetuated generation after generation. I wonder if what I am doing for this one client sitting in front of me is enough.

Not Enough Time

On the flip side, there also just isn’t enough time. After a fantastic session, you may have 7 minutes to bill, maybe write the note, go to the bathroom, and switch gears for your next client who may have gone through hell that week. Then, when one client completes treatment, it’s onto the next (more on that in a minute).

Consultation, the ideal place to have camaraderie for celebrating the wins (particularly in private practice, where you are less likely to be part of a treatment team), is both necessary and a luxury. It is essential for self-care, engaging in community care, and ensuring ethical practices. Thus, using consultation to ask for help with a tricky situation or processing complex countertransference often takes precedence over everything else, including joy.

The Role of Burnout

Part of the challenge also stems from burnout. Burnout is when a system is asking us to do more than we are capable of doing without sufficient acknowledgement, support, or hope for change. Symptoms of burnout include feelings of dread, lack of motivation, feelings of depression, exhaustion, changes in sleep and appetite. Not super specific, lots of overlap with compassion fatigue, secondary-stress, depression, PTSD, etc., and you get the idea.

For today’s discussion, I’m going to look at burnout in the context of the pressure to fill a therapy slot after the biggest win of a client completing treatment. When I worked at the VA, there was high pressure and high demand to finish ongoing care, keep care brief (which is not my MO), and get more people into care ASAP. This was a huge barrier to experiencing any joy in completing work with a client.

Private Practice

Now that I am in private practice, I don’t have formal systemic pressures. No one is monitoring my caseload or waitlists. And I am still acutely aware of how much suffering there is in the world. How much need there is for the support, kindness, understanding, and healing that therapy can provide. This makes it hard not to jump to fill slots as soon as they open.

And unlike at the VA, now there is the financial aspect to consider. An open slot, even if I could use a breather between clients, means lost income. This can be difficult to tolerate, especially as costs are rising across the board. It also goes against our society’s productivity-driven, burnout-glorifying ethos.

Compassion Fatigue

I’ve talked about compassion fatigue before and posed the question: What if compassion fatigue is about losing connection to the meaning of our work? And in turn, struggling with the existential suffering this disconnect creates? I cite thoughts like “what difference does this one ‘win’ make?” and “what’s the point?” as manifestations of compassion fatigue. Feeling like it doesn’t matter what we do, it’s only a drop in the bucket, makes it hard to feel the joy of bearing witness and contributing to great healing. It might be splitting hairs, and I think of burn-out as the “what” (pressure to get to the next client) and compassion fatigue as the “how” (the emotions correlating to that pressure).

State of the Nation

The fear, anger, and stress of what is happening in our nation are confounding the “normal” risks for burn-out and compassion fatigue. For many, me included, it is exacerbating that sense of pressure to help as many as we can while challenging our sense of impact. Am I doing enough? Is this making a difference? (For the record, I HAVE to believe it does. It’s on my radar to make a post on the ripple effects of our work… stay tuned).

Healing is Quiet

Another element I’ve been reflecting on is that in therapy, the wins are quiet. Like I mentioned above, throughout therapy, the wins, especially in the beginning, are often subtle. A win might look like a client being able to label the presence of shame where months (or years) before they would have had no awareness, vocabulary, or trust to be able to identify the cues of shame, label it for themselves, then communicate it to me. And in that moment, they are still feeling the full impact of shame and therefore may have a hard time seeing the significance of “just” being able to label it. And truly, it is a big deal. A win worth celebrating. And yes, the road ahead may still be long.

Also, in our work, we aren’t exactly winning a Super Bowl that is broadcast to millions. Rather, like the rest of the work, the win is just between you and the client. We don’t get to see the full impact, those ripples I referenced earlier. And that “biggest win,” often comes in the form of the client shyly saying they don’t need me anymore, then apologizing and hoping I understand what they mean. I respond with a smile and explain that the greatest gift a client can give me is to not need me anymore, because this means they are no longer just surviving. Rather, it means they are living, and maybe even thriving, which has been the goal all along. It is a beautiful and powerful experience, and shockingly anticlimactic. There are no streamers or fireworks. It’s quiet. It’s bittersweet. It’s strange. And then it’s on to the next.

Losing the Wins

As a result of all this, the wins get lost. They don’t feel as potent as they did in the early days of training. They are harder to embrace because the queue is long. Burnout and compassion fatigue are real. The world is heavy and hard and scary. And “winning” in this line of work is quiet, subtle, gentle, even.

How do we actually celebrate the wins?

1. We have to make the time. Whether in our own processing notes or by asking for time in consultation. For the latter, we MUST encourage each other to do this. I keep wanting to make it a structured part of consultation – five minutes at the end of every session to acknowledge a win. Maybe now I’ll actually do it!
2. Process the win. What is special about this win? What is incredible? Write about it. Collage it. Paint it.
3. Watch Ted Lasso. I ALWAYS think about Ted Lasso when it comes to celebrating the wins. Maybe it’s because of his fantastic victory-dance moves or his cheesy one-liners. I don’t know. But he is my symbol for celebrating the wins.
4. Share your ideas with me. Like I said, I struggle with this. I keep telling myself to do 1 and 2, and have I yet? Nope. I love the idea of doing an art project to represent what this work, in general and with individual clients, means to me. And at the end of the day, I’m tired. I want to switch gears and be with loved ones, reading a great book, or dancing out the day.

For Clinicians: I hope my words resonated with you and normalized thoughts and feelings you may be having. How do you celebrate the wins? How can you improve this? What was one win from this past week? Please share in the comments below.

To get the ball rolling, here’s an example from me: a client shared that they “knew how to take care” of themselves when facing a major stressor. In the past this stressor would have triggered feelings they didn’t know how to understand or label. In turn they would have struggled to connect with their partner and ask for support effectively, resulting in dysregulation and interpersonal distress. Instead, they honored their feelings, engaged in restful and rejuvenating activities, asked for help and was able to receive love and support. Win win win!

For Those Seeking Healing: This may have been an awkward or uncomfortable read for you. It’s a bit more of a peek behind the curtain than my usual posts. I talked more about the inner workings of a therapist’s mind than you may have been exposed to before. If this prompts worries or concerns regarding your own therapeutic experiences, I encourage you to share them with your therapists. Even if it was uncomfortable, I hope that it still came through how much passion and deep care I have for this work. And maybe you’ve gained some helpful insights along the way.