I recently published a book based on six years of research into the complexities of burnout and the healing that individualized self-care strategies can bring each of us. In this work I concentrated on why people get so exhausted and overwhelmed that they lack enthusiasm for what they had previously enjoyed, turn off to others, view themselves as failures, and eventually, if they do not understand what is happening to them, become immobilized. One sure sign that burnout may be beginning to fester is, in the words of a client, “feeling as if I am constantly ‘on empty.’”

We all have what can be described as toolboxes that we carry in order to cope with what comes our way, and hopefully, not just survive, but also flourish. But think about it — if in our personal toolbox all we have is hammers, then everything we see will look like a nail.

And so it was with Marilee (not her real name, of course), a beautiful and accomplished scholar, who by age 23, had completed a doctoral program in music methodology in a noted university. Marilee’s goal was both to write and perform her works. Her postdoctoral professional offers were many, both here and abroad. Marilee chose Paris as she rightly saw that both of her parents were, as she accurately described them, “a combined, totally united octopus — they agree on everything and no matter what I give to them, they want more. They feel entitled to info on every aspect of my life, have opinions on and are sure they are right about everything, and never give me room to make my own decisions. Every time I am with them, or even talk to them, I feel choked, struggling for breath.” And so, to escape this stranglehold Marilee selected a position in Paris. However, the escape she sought was totally compromised. Marilee’s “unfinished emotional business” went with her to Paris. Further, it would have accompanied her to any other part of the world she had selected for escape.

How was this unfinished business manifested? Please read on. Predictably, Marilee’s work went well. Her compositions flowed, and her students adored her. However, her personal relationships, with both colleagues and those she met who wished to be her friends or more, were utterly unsuccessful. Here’s why: Marilee had separated from her parents geographically — but not emotionally. She had run away from them, rather than insist that they view her as an adult. Had she begun to achieve the emotional autonomy she was entitled to before choosing work in Paris, she would have allowed closeness with others. Instead, Marilee experienced every personal question, every offer of closeness, as the same kind of intrusion she had experienced with her parents. In other words, everyone was a nail requiring her hammer in order that she could continue to breathe. It was as if she wore a sign that read: “Keep your distance. Do not intrude on my life. I am too angry for a relationship.”

Without personal relationships to sustain her, in six months Marilee’s symptoms moved from exhaustion to feeling like a complete failure. For reasons her doctors could not diagnose, she developed a painful, itching rash all over her face and arms that medications did not ease. Within weeks she was immobilized — no longer able to concentration on her students or her other professional priorities and responsibilities.

Now let’s look at Evelyn (also, not her real name). Evelyn’s toolbox also contained only hammers, but for reasons very different from Marilee. Evelyn had a younger brother, who was clearly the favorite of each of her parents. While her brother Mark could do no wrong, Evelyn was consistently criticized by her mom for not being thin enough and by her dad as not being a strong enough student. Like many rejected sons and daughters, hoping to win her parents’ love and respect, Evelyn clung to them, telling herself again and again that if she could only do this or that, her parents would finally award her with kindness and love. The sign she always seemed to wear read: “Stay away. My parents are the only important people in my life. Can’t you see that I am unlikable as well as unlovable?”

After graduating from college, where Evelyn was a fine student, she took a job in her father’s accounting firm, and devoted all of her spare time to her mother’s needs. Still, nothing pleased her parents, or brought her their acceptance or an acknowledgment of her devotion. Evelyn began to care less and less about her personal appearance, and although she consulted doctor after doctor, no one could diagnose why her back was in constant spasm. She began missing work, and stopped leaving her apartment. Burnout had reared its ugly head, incapacitating her.

Although both burnout and depression involve a feeling of despair and hopelessness about one’s future, depression is far more difficult to treat. Burnout is both alleviated and prevented through the combination of growing emotional autonomy, which leads to the development of a trusted “emotional sense of direction,” and the selection of self-care strategies that will work for each individual. It is also important to note that disrespectful work settings also cause burnout, which was a partial reason for Evelyn’s misery.

Further, our bodies speak, warning of burnout, and we are wise to listen. Neck-pain (when illness is ruled out) can mean that someone or something in your life is a “pain in the neck.” Stomach pain (when underlying medical cause is ruled out) can be a clue that things are going on in your personal or professional world that you “cannot stomach.” Itching (again, when medical cause is not found) can mean that you are “itching for something.” And back pain (you know what belongs here) can be a sign that someone or something is “breaking your back.”

Both Marilee and Evelyn sought and received the counseling they needed. Marilee’s rash disappeared, as did Evelyn’s back spasms. Each insisted on the important parental conversations and respectful attitudes necessary to affirm their individuality and self-worth. Marilee continues to live in Paris. She is now married, the mom of two, and writes and teaches. Evelyn also has a life partner and is a key, deeply respected executive in the accounting firm her father started. The firm title now notes the founder’s name, followed by “And Daughter” and Evelyn’s full name.

Originally published at medium.com