This isn’t just about burnout, it’s about betrayal.  This article is part of “The Primal Scream,” a series that examines the pandemic’s effect on working mothers in America.

Source: New York Times

By: Pooja Lakshmin


As a psychiatrist specializing in women’s mental health, nearly every mother I have treated during the pandemic fights through decision fatigue, rage and a feeling of powerlessness every day.

This isn’t breaking news. Burnout among parents, in particular moms, has been a defining principle of this global disaster. Clinical-level burnout is defined by a triad of symptoms: exhaustion, a sense of futility and difficulty maintaining personal connections.

And yet, the more I hear my patients use the term “burnout,” the more I think it doesn’t capture the depth of despair they describe. These are mothers who are faced with impossible choices: sending their child to school, and risking viral exposure, or not showing up to work; plopping their child down in front of a screen just to get a moment of peace.

To get another perspective on burnout, I spoke to Dr. Wendy Dean, a psychiatrist who has dedicated her career to fighting moral injury in physicians, which is the concept that systemic problems in the medical industry prevent doctors from doing what they know is right for their patients. Dr. Dean said what working moms are facing is not identical, but it’s similar, and a consequence of “our society’s decision to pursue profit at all cost.”

The crushing toll on working mothers’ mental health reflects a level of societal betrayal, according to Dr. Dean. “This isn’t burnout — this is societal choice,” she said. “It’s driving mothers to make decisions that nobody should ever have to make for their kids.”

“Betrayal” describes what my patients are feeling exactly. While burnout places the blame (and thus the responsibility) on the individual and tells working moms they aren’t resilient enough, betrayal points directly to the broken structures around them.

So what can you do?

A critical first step is to remind yourself that the reason you feel guilty, apathetic and exhausted during this worldwide crisis is due to choices that were made by people other than yourself. You can’t remedy a lack of national pandemic policy or the failure of employers to effectively support families. “How could you have won in this situation?” I like to ask my patients. Nine times out of 10, the solution is a family friendly socio-economic policy that has yet to materialize in the United States.

When it comes to pandemic decision-making, there is no perfect choice: “If I were a better mom, I’d know if it’s worth keeping my toddler in preschool while I’m pregnant,” my patients think. The relentless need to find the perfect solution offers the illusion of control.

When you find yourself mentally spinning in this way, recognize that you have a choice in how you react to and engage with your thoughts. For example, when you fixate on finding the right answer, try saying, “There goes my mind again, telling me there is a perfect answer.” Drawing overt attention to your mind cultivates psychological flexibility, which gives you the emotional space to question whether this line of thinking is productive, or even realistic.

Adding more tasks, even “self-care,” to your to-do list is not a panacea for burnout. In some cases, it may in fact be a recipe for a higher mental load — the invisible labor that goes along with managing a household — and even more guilt when you feel that you failed.

I often tell my patients that the true work of “self-care” is recognizing you are the only one who can give yourself permission to take back your time and energy. This may mean having hard conversations with your partner (if you have one), family members and employer about what tasks are realistic right now, and which items will have to wait (or go by the wayside).

It is not uncommon for my patients to say things like, “I should be doing more.” It’s one way that women have internalized a culture that demands they bear the brunt of caregiving while simultaneously devaluing that job.

When it comes to dealing with such widespread social betrayal, talking to yourself with kindness helps you remember that you are not to blame for this mess. For example, instead of berating yourself for ordering takeout meals three nights in a row, try saying something like, “My home feels chaotic because the world is chaotic, not because I’m a bad mom.” Remind yourself that perfection and order are not the goals — compassion and flexibility are.

Lucia Ciciolla, a researcher and assistant professor of psychology at Oklahoma State University, has found that there are four important factors that align with well-being for moms: satisfaction with friendships, authenticity, feeling seen and loved, and feeling comforted. The quality of our relationships is correlated with emotional health and satisfaction in life, Dr. Ciciolla says. Nurturing authenticity in life partnerships, friendships and family ties can lessen the intensity of burnout.

While it sometimes feels like just another burden to speak up or push for support at work, making your frustration known can help you feel better.

Dr. Kali Cyrus, a psychiatrist and assistant professor at Johns Hopkins University School of Medicine, recommends taking the leap if you can. “The fear of hurting someone’s feelings, bothering them, or getting in trouble pales in comparison to the piece of you that is lost when you don’t do it,” she said. So take one small action at a time. That could mean suggesting that a Zoom meeting be changed to a quick phone call, or inquiring about how performance reviews will account for the demands of parenting in the pandemic.

In the end, there is no simple solution for the massive societal betrayal working moms have experienced over the past year; to pretend so would add insult to injury. My hope is that by recognizing the systemic nature of the problem, mothers can break free of guilt and stress that they don’t deserve.

Dr. Pooja Lakshmin, M.D. is the founder of Gemma, a digital education platform dedicated to women’s mental health, and is working on a book about the tyranny of self-care.

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