The term “wounded healer” was first used by Carl Jung in 1951,(2) but the idea of the wounded healer is universal. Legends and myths from cultures around the world have featured the wounded healer throughout history. Wounded healers endure suffering, loss, and sometimes even complete disintegration, before settling into a place of greater wholeness where they can claim the wisdom and abilities to heal themselves and others.
As clinicians, many of us entered our profession after experiencing a personal healing crisis or seeing a loved one in a health crisis. Unfortunately, our professional training may also have been traumatic, exacting costs not only in terms of time and money, but also in terms of the abuse we suffered.(3) A 2008 study at the University of Arkansas found a significant decline in empathy as students progressed through their 4 years of medical school.(4) Did your empathy remain intact during your training? Refer to “Overall health and the life of a clinician” for more information.
In what ways can these “wounds” manifest themselves?
The challenges don’t stop once we complete our medical training. No matter how long one has been in the profession, there are risks associated with being a healthcare professional. It is not easy to regularly bear witness to the suffering of others. Examples of clinician injuries include suicide, substance abuse, poor self-care practices, and burnout:
1. Suicide.
- Each year, between 300 and 400 doctors commit suicide in the United States.(5)
- The rate is at least double that of the general population(6) and higher than that of most other professions (e.g., teachers, lawyers, veterinarians).(7)
- Suicide rates among female doctors are 4 times higher than in the general female population.(8)
2. Substance abuse. Data on substance abuse among clinicians is difficult to find, but it is clear that it also has harmful consequences.
- In 2001, 7.3% of the U.S. population over the age of 12 met criteria for abuse or dependence on illicit drugs or alcohol.(9)
- Doctor results vary, from below the population norm (4%) to above (8%), depending on the study.(ten)
- A study focused on nurses found that 17% had engaged in binge drinking in the past year (as in the general population) and 10% had used illicit drugs.(11)
- 12% of 751 social workers in North Carolina were found to be “at serious risk” for substance abuse.(12)
- Doctors and other clinicians are more likely to hide their substance use and require more treatment time to recover.(13)
- There is a tendency among healthcare workers to underreport substance misuse by their colleagues.
3. Poor self-care practices. Clinicians are expected to devote their time and energy to the care of others. We value selflessness and self-sacrifice, but these values can have a dark side; we might not seek help for ourselves. Many of us learn that facing our own challenges is a sign of “weakness.” Most evidence regarding clinician self-care comes from studies of physicians.
- An investigation into surgeons found that fewer than half had seen their primary care clinician in the past 12 months. More than 20% had not seen their primary care clinician in the past four years.(14) The unwritten code among surgeons (and others) is to go to work early and stay late, work weekends and nights, do lots of procedures, meet multiple deadlines, and do all of that trying to keep personal issues and emotions from seeping out. the path.(15) Does this sound familiar?
- A 2008 study of 763 doctors of California found that 7% had clinical depression, 35% reported “not exercising” or “occasionally”, 34% slept less than 6 hours per day, and 27% rarely or never ate breakfast.(16)
- A study of 963 medical students, residents and attending physicians suggest that medical training prevents healthy behaviors and decreases the likelihood that they will be practiced later in life.(17)
- The majority of doctors report being in “very good” health, but it seems that improvements are possible.(18)
4. Burnout. Burnout is prevalent among clinicians, and health care organizations are increasingly interested in finding ways to prevent it. Burnout is closely linked to suicide, substance abuse, and poor self-care, in addition to many other challenges clinicians face. Therefore, any discussion of clinician self-care must consider burnout.
- Burnout includes 3 main elements: emotional exhaustion, a reduced sense of personal accomplishment (the work is not fulfilling) and depersonalization.
- To learn more about burnout, including its definition, causes and consequences, see “Burnout and Resilience: Frequently Asked Questions.” To learn more about ways to prevent or reverse burnout, refer to the resilience resources covered later in this overview.
- If you have not done so, complete it Professional quality of life scale a validated instrument that assesses levels of compassion, burnout, and traumatic stress.
- If you ever need to take a quick check-in on your level of burnout (and it’s highly recommended that you do because how well you’re doing can vary greatly from day to day or week to week). ‘other), there are 2 yes or no questions. from the Maslach Burnout Inventory which are as sensitive as the full 22-item test:(19)
- I feel emotionally drained or exhausted from my work.
- I have become more insensitive towards people since taking this job, treating patients and co-workers like objects rather than humans.
Answering “yes” to both of these questions is correlated with a high risk of burnout.
