Internship burn out/boredom

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drsaurusrex

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Hello!

I am about 80 % done with internship and am experiencing a really terrible wave of burnout/disenchantment. I have secured a research post doc that will begin late July which I am excited about and is in a very specialized area that I enjoy (for anonymity I will not specify). However on the rotation I am completing now, it is purely therapy (which I am not interested in, truly...researcher at heart). Regrettably, I notice myself not caring when talking to patients (though I do not show these feelings), and finding that it takes everything in me to get in my car and come to work in the morning... I know I am closing in on the end, but every minute on this rotation feels painful and I find myself becoming depressed. I have many friends, many hobbies, and generally feel great outside of work--but when I am here--oh, is it bad. Anyone else go through this? Does it pass once internship ends? thank you...

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Yes, other people go through this and it often hits a peak right around now. Notice how you feel in the near future when you start talking about termination with your patients. You'll most likely feel better once you are doing more of what you really love.

In the meantime, you need a plan for your own well being and that of your patients. Start with the ethics code.
 
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Hello!

I am about 80 % done with internship and am experiencing a really terrible wave of burnout/disenchantment. I have secured a research post doc that will begin late July which I am excited about and is in a very specialized area that I enjoy (for anonymity I will not specify). However on the rotation I am completing now, it is purely therapy (which I am not interested in, truly...researcher at heart). Regrettably, I notice myself not caring when talking to patients (though I do not show these feelings), and finding that it takes everything in me to get in my car and come to work in the morning... I know I am closing in on the end, but every minute on this rotation feels painful and I find myself becoming depressed. I have many friends, many hobbies, and generally feel great outside of work--but when I am here--oh, is it bad. Anyone else go through this? Does it pass once internship ends? thank you...

If you can identify the more specific reason you are feeling this way, it could help. Maybe its a chronic, and/or treatment resistant population? Maybe chronic pain patients? Maybe the same symptoms over and over...much of which are actually self induced? I know this really get to me, for example.
 
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I and several colleagues of mine at different sites experienced burnout by mid- to end- of internship. Working at the type of site I was at and seeing the reality of working there full-time, it actually helped me realize that I was in an area I didn't want to continue pursuing, and started expanding my options to other types of jobs post-internship year. Internship in general is tough, particularly if you relocated to a different place and/or are devoting all of your energy to finishing internship and everything else falls by the wayside (as it does!).

So it could be that everyone feels that way/regular exhaustion, or possibly it's just not your niche. Like the others have mentioned, I'd consider what you really want to be doing, because sometimes it takes working 40+ hours per week at a type of site that can illuminate what is and isn't a good fit for you!

To sum it up, it does get better!
 
I and several colleagues of mine at different sites experienced burnout by mid- to end- of internship. Working at the type of site I was at and seeing the reality of working there full-time, it actually helped me realize that I was in an area I didn't want to continue pursuing, and started expanding my options to other types of jobs post-internship year. Internship in general is tough, particularly if you relocated to a different place and/or are devoting all of your energy to finishing internship and everything else falls by the wayside (as it does!).

So it could be that everyone feels that way/regular exhaustion, or possibly it's just not your niche. Like the others have mentioned, I'd consider what you really want to be doing, because sometimes it takes working 40+ hours per week at a type of site that can illuminate what is and isn't a good fit for you!

To sum it up, it does get better!
I agree with @foreverbull; I burnt out maybe halfway through internship, as did practically everyone at my internship site. We were mostly research-oriented interns and just not into full-time clinical work. It gets better! Congrats on securing a postdoc! In the meantime, it might help if you put extra effort into clarifying what goals (if any) your clinical experience at this site could help you achieve in the meantime. We shifted my caseload a little bit in anticipation of the kind of postdocs I applied to.
 
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No grand words of wisdom here - just writing to say I can relate to you and your experience. I'm someone who needs to be doing lots of different 'types' of things to feel fulfilled. Going from teaching, researching, mentoring, along with doing assessment and intervention to primarily providing intervention services has been tough, even though I am at an internship that allows me to hone the skills and work with the populations I had desired. Internship felt fulfilling until I landed the faculty position I really wanted early in 2017 and since then I've found my mind always drifting towards prepping for that instead of gaining from the experience and training I'm currently receiving.

A couple of thoughts that have been helping me: I got realistic with my supervisors about the income generation aspect of internship. Most internships, from my understanding, do have a certain amount of money that needs to be brought in from interns' work to stay fiscally solvent (even though most internships actually lose money in the long run) and so they have expectations that aren't necessarily shared with interns. I asked pointedly about them and am making sure I am meeting those expectations while adjusting the rest of my time in the program to gain the skills I think will be beneficial for me going into my faculty position (e.g., getting more experience supervising, increasing my amount of guest lectures, writing with colleagues, and working on grant proposals). I'm at an internship where I feel comfortable speaking up and my supervisors are fabulous in helping me to get what I want out of internship. For me knowing the 'behind the scenes' of what higher-ups need to see for the internship to continue was extremely helpful and now I feel more free to adjust my experience. I've also been encouraged to take mental health days, and that's been helpful (even if that meant simply giving myself permission to write while my family was away for the day...). Before I had been spending most of my evening and weekend free time writing to try to stay productive and I've been backing off of that and taking time to enjoy my location before moving this summer. I'm working on giving myself permission to say 'no' to cases, to set boundaries on my time and energies, and in doing so, to potentially disappoint colleagues. It's difficult, but it's doing wonders for my mental health and is certainly a piece of professional development that I have struggled to learn over the course of my training so far.
 
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I felt exactly the same right around the 8 month mark. I felt like my job prior to internship (which at that point had already offered me a post-doctoral position) was a much better training site with more competent providers and supervisors, better pay, better policies and procedures, a much nicer facility, and a more enjoyable population. I was very much "over it" near the end, I couldn't wait to get out of there and back to what I felt like was my actual career and just kept reminding myself I was in the home stretch.

I also had a lot more autonomy and responsibility at my pre (and post) internship job. I went from being the lead therapist of an intensive outpatient program to co-facilitating a DBT group.
 
I felt a bit burned-out at that point in internship, but it was mainly related to eagerness and anxiety about the next steps. For me, providing services to the patients was the one area where I felt productive and useful, but that was and continues to be my focus. I was also beginning to develop administrative and training skills that I see as part of my commitment to helping patients. Now if research was my main gig, I would have been so over it all it wouldn't have been funny. What is a bit scary is that the OP's perspective is so different from mine or my practicing colleagues that it raises a lot of questions about our clinical research.
 
I can't speak about internship necessarily, but I've felt that way providing nothing but psychotherapy day in and day out for up to 7 patients per day with a very high risk/low improvement rate population. That takes a toll on people. I've learned I need a little more variety. I notice after a long period off work, such as vacation, I'm a way better therapist. That's how I know I'm in the right general field but the situation and balance is missing.
 
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I also burned out on the volume of clinical work during internship, as a person who preferred to be primarily focused on research, so I would like to validate that your feelings are totally normally in my opinion.

What helped me was to try to re-examine my strengths and weaknesses as a clinician, particular in regards to how they might relate to clinical skills or expertise I was going to need in my future hoped-for research career. Then I tried to push myself outside my comfort zone and ask for supervision around those areas. (Example: I didn't know ACT very well, but I had an inkling that I may want to incorporate third-wave intervention strategies into a small piece of my future research. I had one supervisor who was trained in ACT, so I tried to get more ACT experience, knowing it might well be the last time I had a regularly scheduled free-to-me supervision in ACT.)

Also just use up your vacation/sick days to give yourself a break, and try to have fun outside work hours. I lived somewhere that I didn't really like and was about to move WAY far away never to return, so I tried to embrace and take advantage of everything possible to do there that I'd never get to do again (even though it was a short list, but hey, do what works).
 
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The whole internship process was insanely frustrating to me because I had what I considered a better full time job before I started my internship. I took a huge cut in pay, benefits, and responsibilities in order to take a "training" job that had no training budget and provided fewer weekly supervision hours than my "job" job did.
 
The whole internship process was insanely frustrating to me because I had what I considered a better full time job before I started my internship. I took a huge cut in pay, benefits, and responsibilities in order to take a "training" job that had no training budget and provided fewer weekly supervision hours than my "job" job did.
Curious about how your program/schedule operated that allowed you to have a FT job w benefits-- how'd that work?
 
Curious about how your program/schedule operated that allowed you to have a FT job w benefits-- how'd that work?

It was an unfunded program so my only responsibilities were coursework, practica in 2nd and 3rd year, and my dissertation. I worked full time my 1st and 4th years in the program and part time my 2nd and 3rd years. I scheduled most of my classes as early in the morning as possible and had 2-3 days a week where I would work evening hours.
 
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