What the work can hold
This is the part of my practice concerned with burnout, responsibility and the cost of keeping things running. Physicians, founders, attorneys, clinicians and other people in demanding roles appear throughout my writing on this subject. The starting point is what the work has asked of you, what you have had to put aside, and how that arrangement is affecting your life now.
The question I learned to ask is: what has your strength been required to carry, and what would change if it no longer had to carry everything? That leaves room to talk about the job itself, the institution around it, the responsibilities you chose, and the ones that became yours without much of a choice.
The person outside the job
We look at how much of who you are has become tied to the work: your sense of worth, your place among other people, the feeling that being useful is what keeps everything steady. We can also talk about the parts of your life that existed before this role and the parts that have had very little room alongside it.
I write about perfectionism, moral conflict and the pressure to keep performing. In the room, those are subjects to examine with you. I want to hear what the demand actually is, what you believe would happen if you stepped back, and which parts of the situation are within your control. You do not need to translate all of that into a polished explanation before asking about therapy.
Questions people ask
Do I need a diagnosis to ask about burnout & moral injury?
No. You can begin with what has been happening, what it costs you, and what you want help understanding. A webpage cannot diagnose you or decide what treatment you need.
What is a first fit conversation for?
It is a chance to ask how I work, describe what you are looking for in broad terms, and clarify location, scheduling, fees, insurance, and current availability before either of us decides about ongoing work.
Ask about burnout & moral injury therapy.
You do not need the whole story ready. A broad starting point and your location are enough for the initial inquiry. Keep clinical detail out of email and voicemail; the conversation is the place for specifics.