When therapists need a break

Indian Express

15-06-2025

Lisha Chheda, a Mumbai-based psychologist and co-founder of Rubaroo Breaking Silences Foundation, a decade-old NGO working with survivors of child sexual abuse, began her practice 13 years ago. 'Human stories always intrigued me. Plus, being the older child, I have always been a caregiver,' shares the 37-year-old, who would juggle her time between her NGO and private practice, where she would see eight to 10 survivors a day. But two years ago, she noticed herself shutting down in a session.
'I was too exhausted to even write notes, something I'd never skipped. I just slept,' she shares, adding that it wasn't so much about that session as it was about the cumulative toll that her work was taking. It was the same time when her NGO was rescuing children who were sexually abused. 'We were handling the legal procedures and the unpredictability of the situation. It required my involvement for over a month and left me in a constant state of anxiety and fatigue,' says Chheda, who has a Master's in Counselling Children and Young People from University of Nottingham, UK.
She sought therapy, even scheduled SOS sessions to cope. 'Once the children were safe, I compartmentalised both my schedule and my mind. I consulted fellow professionals, drew up a realistic timeline and planned a break where I decided not to see children or take on any work at the time.' Following the break, she reassessed her workload. Chheda now sees only one to two people at the NGO and three to five clients in her private practice. She acknowledges that she was able to cut down because her private practice isn't her only source of income.
For Mumbai psychiatrist and psychotherapist Dr Syeda Ruksheda, 50, who has been in the profession for over 25 years and has seen all kinds of clients, from drug addicts to young students with suicidal tendencies, nothing rattles her. But about two decades ago, one man managed to get under her skin.
'I had a client, a woman in her late 20s with a two-and-a-half-year-old daughter. She had an arranged marriage with a man who wasn't very wealthy but was a respected leader in his community. At home, however, he was abusive. It began with emotional and verbal abuse and eventually turned physical. She wanted me to see her husband and after much persistence, we managed to get him to come in,' says Dr Ruksheda. The meeting shook her in a way few cases ever had. 'His abuse was gendered, purely because he was a man and she was his wife. I hated his guts,' she says, 'But I had to meet him to help the woman and so we did. I still remember it affecting me deeply, making me anxious before our meeting. I would practise deep breathing, tell myself to stay professional, maintain a poker face and not get pulled into his narcissism. After each session, I would pace in the clinic, have a cup of tea and make sure to hit the gym in the evening. I even ranted about it at home, sometimes to friends, to let it out.'
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While there is limited empirical data, an article, 'Burnout in Indian Psychiatrists' (2018) by Hyderabad-based psychiatrist Dr Poduri Gopala Sarma, highlighted that a survey of 110 Indian psychiatrists found 46 per cent had burnout in at least one dimension (personal, work or patient-related), with 32 per cent of psychiatrists meeting burnout criteria.
Empathy fatigue is real, admits Thane-based educator, psychotherapist and neuropsychotherapist Pooja Joshi who has been practising for 13 years. 'It doesn't cripple you but slows you down,' says Joshi, 38, who separated from her husband two years ago and now lives with her two 'girls' — a 10-year-old Shih-Poo and a three-year-old Golden Retriever. On an average, she works six days a week and sees five-six clients every day. On days, she finds herself 'cerebrally paralysed', she spends time with her canines or goes for a swim or meets her father who lives close-by. 'The best thing about him is that he listens without offering me any solution. I also journal.' She also takes two days out every 45 days to do nothing. 'I don't meet my parents or friends. Even if I step out for a drive, I don't stay away from home consciously for over an hour,' she says. It means sleeping, reading (a lot of Osho and self-help) and baking. 'It doesn't need me to spend my brain at all. It is about precision, about following a recipe to the T,' says Joshi.
Recently, the Netflix series Adolescence offered a compelling glimpse into the work of a psychologist. In the real world, Mumbai-based forensic psychologist Krupa Nishar navigates similar challenges every day. Soon after completing her master's degree in forensic psychology in 2019, she joined the Gujarat-based National Forensic Sciences University as an assistant professor, where she trained Indian and international police officers in forensic psychological tools. Later, she moved to Delhi to work at the Bureau of Police Research and Development. Currently in Mumbai, working with an international NGO, Nishar has interviewed prisoners, sexual offenders, murderers and sexual abuse survivors.
While Nishar tries her best not to let work seep into her personal life, she admits that it sometimes does. 'I know areas in Mumbai where sexual abuse cases or violent crimes are prevalent. When I pass through those neighbourhoods, I'm on high alert. It changes the way I walk, the way I behave. I know who's looking where. I've always been tiptoeing, which is good for my safety but it's also tiring,' she says.
She acknowledges that the NGO sector is now more mindful of burnout. 'Many have mental health support systems for psychologists. There's a growing awareness that burnout is inevitable and people might need to take a break and that's okay,' says Nishar.
While much of the conversation around mental health focuses on coping, prevention is just as crucial. For Dr Zirak Marker, 51, a psychiatrist who works closely with children and adolescents, maintaining emotional distance is essential but far from easy.
To avoid counter-transference — projecting his own emotions or experiences onto patients — Marker practises what he calls detached attachment. 'You have to preserve your therapeutic energy. If you get too emotionally involved, you'll burn out,' he says.
Yet, nothing prepared him for losing a patient to suicide. It happened a decade ago. The young adult had been in therapy for nearly five years and had shown marked improvement. 'But when someone decides to end their life, it's often carefully planned. In the weeks leading up to it, they seem calm — that's the hardest part. You think they are getting better, but they have made up their mind.'
The news left him reeling. Then came the guilt: 'Did I do enough? Should I have tried a different approach?' Although the family didn't blame him, the self-doubt lingered. 'I hit a low point. I questioned whether I was even meant for this. I felt exposed, vulnerable. Then came the shame. Eventually, I sought help.'
Despite the emotional toll, stepping away wasn't an option. Marker, who balances roles at the Aditya Birla Integrated School, Mpower, and his private practice, continued seeing up to 10 clients a day. 'There was no luxury of taking a break,' says the south Mumbai-based psychiatrist and father of two. Though he insists it didn't affect his clinical judgment, he became hyper-vigilant. 'If someone mentioned suicidal thoughts, I'd give 110 percent to ensure their safety.'
Even with years of experience, burnout creeps in. For Marker, the first sign is a headache. 'That's when I know I need to pause. I switch off by watching something silly, going for a walk or swim, catching up with a friend — anything to step away from my emotions for a bit.'
Others in the field, too, have had to confront the emotional weight of their work. Mumbai-based Irawati Joglekar, 36, has spent 13 years working with trauma, with about 80 per cent of her clients dealing with Post-Traumatic Stress Disorder (PTSD), often linked to childhood abuse.
The first time the work felt overwhelming was seven years into her practice. The exhaustion took a physical toll — disrupted sleep, constant fatigue and creeping self-doubt. At the time, she was juggling multiple roles, working with NGOs, schools and even counselling at Mumbai's Tata Institute of Social Sciences (TISS). 'Therapists aren't paid well until they build a private practice and I was trying to do it all.' She sought therapy herself, which brought some relief. But it wasn't until 2021, when she found her current therapist, that things truly shifted. 'It helped me process both burnout and personal challenges. I started going regularly and made a conscious effort to reduce my workload,' says Joglekar.
While urban practitioners often grapple with daily emotional burnout, working in conflict zones brings a different magnitude of trauma. Dr Abdul Majid, born and raised in Kashmir, has lived through the Valley's most violent years, enduring personal loss and disrupted student life, besides treating patients with bullet wounds. Before his MD in psychiatry, he was posted in a rural area as an assistant surgeon for about nine months. One day, his cousin came to the casualty ward when he was on duty. He was shot by an unidentified gunman. He died while they were mounting him onto an ambulance to be taken to a hospital in Srinagar. A decade ago, he also witnessed the loss of his close friend who was in the police.
'The psychological impact on Kashmir's general population is immense,' says Majid, 50, who now heads the psychiatry department at the Advanced Centre for Mental Health, SKIMS Medical College, Srinagar. He sees around 70 patients daily across his hospital OPDs and private clinic. Has it ever taken a toll? 'Yes,' he says, 'We set boundaries but it is our duty to help. I believe God has made me do this. I may break down at times but it's not persistent. I regroup the next day, come back with new ideas, energy and enthusiasm. When I see a patient doing better after a few weeks of intervention, it brings me great joy.'
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They say you must fill your own cup before pouring it into others. Every therapist agrees that sustaining this work requires deliberate care, discipline and self-awareness. Over time, each one has developed rituals, routines and boundaries to manage the emotional demands of their profession.
For Chheda, this includes working out, reducing screen time, seeing her own therapist once a week and walking her dog every day. Dr Ruksheda ensures she has non-work hours where she takes off her psychiatrist's hat. She prioritises adequate sleep, exercises four times a week, spends quality time with her family and carves out 15–20 minutes each day to simply do nothing. She also takes three to four vacations a year. 'You get different energy from different people,' she says, explaining her preference for a different destination each time. As part of her coping mechanism, she also watches online content and reads fiction. 'I don't want to read non-fiction because my life is already very heavy. I read fantasy because it is not my life, I don't have to make decisions. Romance tops the genre, followed by thrillers. When it comes to content, it's similar, just add vampires,' she says.
Nishar begins her mornings with a walk and has recently started visiting spiritual centres for meditation, while Marker protects his weekends, exercises regularly and turns to art and horse riding. 'Art is my therapy, while being around animals is incredibly healing. I have grown up around horses at my family home in Matheran. We know a few locals now who have horses there, and I spend time with them. Silver, who was named based on his silvery grey colour, continues to heal me,' he says.
Joglekar limits herself to no more than five clients a day — six in an emergency — and is intentional about the kind of cases she takes on. 'I avoid working with multiple clients experiencing active suicidal ideation at the same time,' she says. Regular therapy, planned holidays close to nature and acknowledging her own limitations help her stay grounded. 'I plan breaks months in advance so I don't reach a point of desperation.' Majid's unwinding includes exercising daily and spending time with his wife, his children and his nephews.
While these mental health professionals aren't untouched by pain, they have found ways to keep going — one session, one story, one survivor at a time.