“How do I maintain my caring when my clients aren’t doing what I want them to do? How do I have ‘healthy detachment’ and not burn out?”


Providers use the word "detachment" to describe a way of protecting self from clients – from over-investment in a client's emotional life, from taking on the client's problems and feelings as one's own. Providers sometimes equate this with a lessening of caring. But to not care, to "detach" one's caring from one's clients, is to deny oneself perhaps the best reward available from the work – the experience of one's caring. When we get into this work initially we often anticipate that our caring will be the currency that will buy results in the lives of our clients – if we just care enough, give enough, surely they will respond. When the reality of our experience with clients offers us much less than a clear causal relationship between the quality and quantity of our caring and the percentage of clients behaving in ways we wish, we can begin to feel that our caring is "costing" us too much, and we may become stingy with our caring; hoarding it so as to not "squander" it on unappreciative clients – in other words, clients who are not demonstrating their appreciation of us by doing what we want them to do. Burnout, then, is a symptom of inappropriate expectations of caring combined with a lack of source of success other than the client. That provider who protests or behaves in ways that suggest she/he no longer cares, likely cared, and experienced his/her caring tremendously, at the beginning. But with the on-going anticipation that this caring would be the critical causal agent for client change disappointed over and over again, the provider dares not continue to care – it's costing him/her too much!



Healthy detachment, then, would be detachment from those expectations, rather than detachment from the client. Healthy detachment requires a definition of success that for each provider lies in his/her own behavior, not the client's. With that definition, when a client comes back to the clinic once again infected, or pregnant, or using drugs, rather than seeing that as evidence of either the provider's inadequacy, or the client's failure, the provider might be able to avoid assigning blame, and not only be ready to problem-solve, but to show genuine caring and concern about what has happened. Rather than saying "Where did I go wrong?" or, directed at the client, "Where did you go wrong!" the provider might be able to say "Something got in the way of the client's willingness or ability to change that behavior. Wonder what that was?" When you get your ego out of the process, your heart can remain available.



A more personal example might reinforce this idea of healthy detachment. Many of us have children whom we adore, and who have significantly fumbled in their behaviors and life choices. Particularly during our children's adolescence – that time when the struggle for power and separation may be most acute on both sides of the parent/child relationship – when our child acts in unacceptable ways, we might strive to separate from our responsibility for their actions. "He's a young man; he's making his own choices and has to accept the responsibility and consequences." Yet, when that same young person is showing his/her best self – kind, generous, successful, responsible – we may be likely to think with pride and joy, "I'm his/her parent! Who she/he is, is in part because of me!!" But we can't have one without the other; can't claim responsibility for the good stuff while refusing ownership of the "bad." And, in truth, ownership of neither belongs to us, and claiming that does not nurture the development of the child.



What belongs to us is our own behavior, and therein lies our source of success: A parent might ask, "Have I been available to my child as a resource to support his/her maturing, even though she/he might not have availed his/herself of that support?" And, if the answer is yes, then success is present in the only way that truly belongs to the parent – his or her own behavior. Of course, this doesn't mean that one doesn't celebrate the child's – or the client's – successes, or feel sadness over his or her slips. It means that one is clear about what belongs to whom, and that by not seeking to define one's self and one's self-worth through another's actions, one can risk continuing to care.