Ep #390: When Helping Hurts: Codependent Habits in the Healing Professions

This is Feminist Wellness, and I’m your host, Nurse Practitioner, somatics and nervous system nerd, and life coach Béa Victoria Albina. I’ll show you how to get unstuck, drop the anxiety, perfectionism, and codependency so you can live from your beautiful heart. Welcome, my love, let’s get started.

Hello, hello, my love. I hope this finds you doing so well. Let me guess, my tender, sweet darling. You are the one who always just knew how to help. You could read the room before you could read a book. You spotted the tears behind the tight smile. You felt the tension in someone's jaw before they even said a word. You know when someone needed a blanket, a glass of water, a deep breath, and you gave it instantly, automatically, before they even knew that they needed it. And you got praised for it.

You got called all sorts of great sounding things: mature, an old soul, intuitive, kind, generous. A natural caretaker, a born nurse, future therapist, the glue in the family, the one we all turn to. You didn't just help, you became the helper. It became your role in life.

So beauty, it's no wonder you landed where you did, in the clinic, in the ER, in the therapy chair, on the hotline, at the intake desk, in the classroom, at the shelter, behind the social services desk, in the yoga studio, at the nonprofit in hospice care. Maybe you're a nurse, a therapist, a teacher, a social worker, a counselor, a coach, a case manager, a crisis intervention specialist, a body worker, a doula, a chaplain, a community organizer. Maybe you work in harm reduction and refugee services, in special education, in elder care, in disability support or disability law.

My beauty, you chose a helping profession, but helping probably didn't start with your job. It likely started long ago, likely in your family of origin. For so many of us, helping was our survival strategy. Your anchor, your compass, your identity, a role you could play with ease, so they were looking at you helping, not looking at you.

When you didn't feel safe being centered in yourself, when you didn't have the consistent mirroring and attunement you needed, when love felt conditional on how helpful, how good, how needed, how A-plus you were, you learn to earn belonging by disappearing behind all of that. And so your brilliant nervous system, wired through years of unspoken roles and silent agreements, learned to scan outward and prioritize others. First, fast, always.

In somatic body-based terms, this created a blended nervous system state, a sympathetic drive to do, to fix, to care, to rescue, entwined with a dorsal collapse of self. You became a conduit for other people's needs while dissociating, disconnecting from your own. We talked about this mixed state of functional freeze at length in episodes 246, 247, and 248, and it's so common amongst us, it has a whole chapter all its own in my book, End Emotional Outsourcing.

And listen, it's so brilliant. Like our codependent mind that is never broken or bad, it's brilliant. It's adaptive. Doing this is what your system learned to do to survive. And you've been unconsciously practicing for your helping profession role your entire life.

But here's where it gets insidious. In a white supremacist, capitalist patriarchy, that adaptive state is not only accepted in healers and helpers, abandoning ourselves is rewarded. Because medical institutions are built on self-abandonment. Schools expect teachers to buy supplies with their own money and work unpaid hours grading and planning. While their safety?

Social work valorizes martyrdom. Nonprofits run on the emotional labor of underpaid staff who are told their mission should be payment enough. Psychology programs often skip the nervous system altogether, let alone teach you to track your own, which I also didn't learn that in nurse practitioner school. You're expected to pour and pour without refilling. And if you say you're tired, you're told to like meditate or there's a staff pizza party. Maybe drink some water, maybe be more resilient.

But darling, no amount of box breathing will fix a system that runs on your exhaustion. Oh, and if you're in private practice, if you thought going solo would save you from this pattern, you might have discovered a cruel truth. You probably brought the codependent perfectionist and people pleasing habits with you. Now, you're not just over-functioning in sessions, you're doing it in your business. You're undercharging because you feel guilty. You're giving extra time just this once, which becomes every time. You're texting clients or patients back at 9:00 p.m. because their pain feels urgent and your boundary feels mean.

You're working evenings, you're working weekends, because saying no to a client or patient feels like abandoning them. And abandonment, that is the thing your nervous system fears most. You built your own practice, thinking you'd have freedom, but emotional outsourcing doesn't respect autonomy. It follows you. It whispers that your worth is tied to your availability, that good practitioners don't have limits, that if you were really compassionate, like if you really cared, you just answer one more email. I mean, how are they going to get by without you, right?

And so the business suffers. Your calendar is full, but your bank account isn't. You're exhausted, but you can't figure out why. You chose this. You're the boss, except you're not. Your codependent patterns are running the show and they're running you into the ground.

When you're fielding calls, staying late, missing lunch, swallowing tears in the supply closet, grading papers at midnight, fighting for your clients or your students or your patients like they were your own children, because in many ways they feel like your children or your siblings or your younger self, you're not just doing your job. You're reliving your original role.

From a polyvagal perspective, codependent patterns stem from a nervous system stuck in chronic hypervigilant attunement. So when your safety depended on someone else's mood or behavior, your brilliant system adapted by focusing outward. You learn to track others' cues, not your own, right? So smart. Over time, interoception, the ability to feel and interpret your own inner signals, dulls. Your breath becomes shallow, your digestion sluggish, your heart rate variable, unpredictable. Your jaw, oh, so tight. And this dysregulation becomes normalized in the helping professions.

It's just how we do. I mean, how many providers eat lunch standing up? How many therapists hold their pee between sessions? How many teachers go all day without drinking water? How many social workers skip breaks to finish case notes? How many coaches ignore their own chronic pain while guiding everyone else towards wellness?

The irony is devastating. The very people entrusted with caring for others often have the most depleted nervous systems ourselves. When emotional outsourcing, when codependent habits run your caregiving, your worth becomes entangled with your usefulness. Your sense of safety is yoked to how much you give, how well you perform, how many crises you avert. You can't rest when you're off call because your system's still scanning. You feel guilty saying no. You worry you're not doing enough in a deeply broken system. You take on more cases, more hours, more emotional labor, more projects, more.

And it's never enough because most of us never learned that we are enough. This is complex because we are working in broken systems and we have good hearts, loving hearts, giving hearts, kind hearts that want to be of service, that want to help others, but we don't realize the ways we're abandoning and failing ourselves in the middle.

We'll be back in just a second and I'll share two of my favorite remedies, two practices to start shifting now. Not because they're going to change the whole system of medicine and mental health care and education, et cetera, but so you can start to come back to yourself bit by bit, moment by moment, so you can make the decisions for your clients, your patients, your students, your business, your practice, your world, from interdependence, from grounding, from everything we talked about in episode 360, and not from a lack of rest, not from living underneath the burden of trying to be perfect and trying to be everything to everyone. So let's take a moment and I'll be back to talk remedies.

All right, my beauty. I want to share two practices that you can start using now to shift your experience so you can start to see where emotional outsourcing may be showing up in your world, in your practice, in your care, in your service, so you can start to come home to yourself. After every session, appointment, client interaction, class, home visit, whatever.

Take 90 seconds to orient your nervous system outside or looking out a window if possible, looking far in the distance and then closer. Oh, and if you're like, wait, what is I'm new here. Hello. What is orient your nervous system? Go to BeatrizAlbina.com/meditation. I have a suite of meditations, nervous system exercises, orienting exercises for you to download for free on the house. I love you. Download them. Learn to orient. It basically means looking around and letting your nervous system come home. So, you're going to take five seconds to five minutes, however long your nervous system needs to orient. And then take 90 seconds to physically discharge the sympathetic activation from your body.

Even if you don't feel worked up, even if you don't feel stressed by the interaction, take the time to shake your hands out, roll your shoulders back and forward, press on the desk, pull up on the desk. Don't go throwing tables. Take your hands and push gently on the wall, roll your shoulders into it and out, and take three deep breaths in and a long exhale with sound, with sound. So that means sighing, humming, groaning, whatever wants to come, let it.

This is neurobiology. Way back in episode 3, so in 2019, we talked about completing the stress activation that your body entered when you attuned to someone else's pain because doing that is your job. And so I posit that dealing with that activation in your body and managing it by attuning to it, by honoring it, by respecting it, by showing up for it is also part of your job because if not, you burn out and then you're of no good to anyone. You burn out and you can't help the next client.

Also, if you skip this, that activation, that 0 to 10 of stress, if each client is a 0.25, that's going to add up pretty quickly to a lot of stress in your system. So that activation accumulates. And I highly recommend that you take the time to do this after every interaction. Do it every time for two weeks and notice what shifts. If nothing shifts, forget about it. Who cares about neurobiology science? Don't do it. But I've never, I recommend this in Anchored all the time. I also recommend this in The Somatic Studio, my self-paced courses. I've never had anyone actually do this for two weeks and not feel a difference.

Listen, why not? And listen, if you're like, I don't have time between each patient to do a whole thing, or like, you know, I'm a family nurse practitioner, so I would be like carrying a computer from room to room. I don't have time to go somewhere private and do this. You really can put the computer down and just shake your hands or just push your feet into the ground or just push on the table and just take a breath in.

Everyone's sighing in healthcare. It's not like anyone's going to notice. Really, one of my favorite things about living in Buenos Aires and in New York, no one's looking at you. No one notices what you are doing. Just take care of yourself and your nervous system. And if someone thinks it's weird, you can explain the science and if they still are judging you, that's on them for being a judgy pants. You don't have to not take care of your nervous system because some judgy pants is going to judge you. The math about judgy pants is they judge. It doesn't matter what you're doing, they're going to judge. So just do what you want to do. Just attune to you, attend to you. You're going to be a better clinician, a better teacher, a better everything. So put your wellness and the wellness of the people you're here to serve and take care of above anyone else's thoughts or feels about how you're doing it when it comes to taking care of you.

Oh, I went on a rant. I went on a rant, but I'm glad I did. It's a good one. All right, practice two. You know I want to give you 473 practices, right? Because I want to help others in the helping profession so much, but we got to go slow and steady. We got to take kitten steps or we're going to overwhelm your nervous system. If you want to dive deeper into this, come, join me in Anchored. I have not had a group since 2019 that wasn't about half doctors and nurses and teachers and social workers and other helpers. So come.

All right, so two, the second practice is the somatic boundary check in. This is such an important one. Oh, it's so important. So before saying yes to anything, an extra appointment, a fever, a case, another committee, one more student, pause and ask your body. Pause and ask your body. We're going to orient, you're going to ground, you're going to find your feet, you're going to find the ground, feel into your body. Does this feel like a wholehearted yes from my overflow? And you might not know what that feels like. So hold on for the second part. Or does this feel like I'm afraid of how I'll feel if I say no? Oh, that question's rude.

Does this feel like I'm afraid of how I'll feel if I say no? I can also simplify it. Am I saying yes because I'm scared of how I'll feel if I say no? Oh, no. It's so revealing. It's so revealing, right? It's really a challenging question. Then place one hand on your heart and one on your belly. Feel your own weight and heat through your hand. Breathe. Notice if there's tightness, collapse, holding. A true, grounded, I'm actually available, yes, feels spacious even if it's hard.

An emotional outsourcing codependent yes feels like bracing. And listen, at first, you don't have to change your answer. You just start noticing the difference. Awareness is the first door and once you've walked through it, you're well on your way.

Because my beauty, all of this isn't just burning you out. Having, being the helper be your actual identity, right? It's not the helping that's the problem. It's that it's your identity, right? Such that you say yes without pausing. You do one more thing without checking in. And so it's breaking your body. It's wrecking your relationships because are you showing up grounded and whole and vibrant at home? Or are you giving it all at the hospital or the clinic or the school or the wherever? Right?

This habit of making this helper role our entire identity keeps us from being the energized, boundaryed, whole people we can be, living the whole life we deserve. Beauty, while your capacity for attunement is a profound strength, it truly is. While your presence has likely saved so many lives, improved so many lives, created ripples of healing that stretch far beyond your sight, it can also cost you everything if you don't know where you end and your patient, client, student, or caseload begins. If those two are synonymous.

So what if your work doesn't have to cost you your health? What if your empathy could come from wholeness, not self-erasure? What if you could serve from interdependence instead of codependence? Interdependence says, "I can care with you, not for you. I can attune to your needs without abandoning my own. I can be rooted in my body, my breath, my boundaries, even while offering support."

Darling, this isn't just poetic idealism. It's neurobiological. When you're anchored in a regulated state of ventral vagal safety, your capacity to connect actually increases. You can co-regulate without collapsing. You can hold space without absorbing. You can offer presence without losing presence with yourself. It's not about detaching or hardening your heart. It's about sourcing from within.

Interdependent healing means you notice when you're holding your breath in session and you consciously soften. You eat lunch sitting down away from your desk every chance you can. You say, "I need to check in before taking on that extra case." And you're saying, I need to check in with myself. You don't need to say it out loud. You feel your feet on the ground while listening to or attending to trauma. You end your day with a practice that brings you back to yourself. You recognize that your well-being directly impacts your ability to serve.

And when you do this, it all changes. Your sessions get deeper and more attuned. Your patients feel safer, not because you overextend, but because your body and your nervous system are safer to be around. Isn't that amazing? Your work becomes more sustainable, more joyful, more impactful. Your identity expands beyond your title. You become more than the helper. You become a whole human.

I want to be clear, this shift isn't about blaming you for surviving in the only way you knew how. It's about freeing you from a model of care that asks you to vanish. You don't need to be a better helper. You need to remember that your humanity, your wants, your needs, your preferences matter too. You get to eat when you're hungry. You get to rest when you're tired. You get to say, I can't hold that right now, and you get to keep showing up for your people, not as a hollowed out hero, but as a regulated, rooted, radically loving force.

This is what it means to heal the healer. And yeah, we're going to need a system-wide shake up to make it really happen in large scale. But we can only do what we can do while we do the work to have an impact on the systems around us. So while we do that bigger work, while we join our union, while we write letters to the Board of Directors, while we work to make bigger change, we turn inward towards ourselves, to shift from codependence to interdependence. Because in that process, it's not just your life that changes, it's every life you touch and you touch so many.

To those in scrubs and stethoscopes, in classrooms and community centers, on Zoom calls and hospice visits, in waiting rooms and trauma wards, scrubbed in and at kitchen tables doing intakes, on playgrounds supervising recess. I see you. I honor you. And I want more for you because the world doesn't need you to disappear in service of others. The world needs you whole. You need you whole, and you deserve to live a life where you feel that in your depth.

I'm here, speaking these words as a prayer, as a spell, as a hope for humanity and for all of us who grew up in the role of helper in our households, in our worlds, in our communities, all of us who are of service. May we find a way to bring in ease for ourselves, our good, and for the good of all of those we care for. Thank you for being here. I'd love to have you join us in Anchored, where we can do this deep, real work in community. Let's do what we do.

Gentle hand on your heart, should you feel so moved, and remember, you are safe, you are held, you are loved. And when one of us heals, we help heal the world. So true. All right, be well my darling. I'll talk to you soon. Ciao.