Inside the pressure cooker



I am sure it is not exactly a novel insight that during the period of the pandemic there have been a series of polarisations, which have far but helped us with maintaining any sense of social harmony and collaboration. One of the most common forms this has taken is creating two camps of adults, those who have too much work in their hands and those who have too little. As a therapist, a keyworker in the pandemonium of mental ill health that the pandemic has generated, I have most definitely been in the former camp, very busy and at times, stretched or on the brink of overwhelm with the given workload. And yet, during the last year, I have not stopped being really surprised by the extremes of overwork and total burnout some of the people around me have subjected themselves to. 

I am not allowed to share clinical material in this public forum, but I think it may be helpful in order to better highlight the emotional reality of the excess of overwork I am attempting to paint to create two fictional case studies of what this may feel like. Here they are:


Pressure cooker effect, case study 1:

Ellen is a civil engineer. She works on projects with tight deadlines. One of her latest projects will coincide with a return to the office after a year of online work and a public presentation to the team. To add to the pressure cooker effect, she has been offered a slot to have the Astrazeneca vaccine on Saturday morning, while her presentation is scheduled for Monday. Ellen is worried about having the vaccine, as she has a condition called thrombophilia, which predisposes her to blood clots. In any case, she needs to gear up for the presentation no matter what. For the last year, she has lived alone in London after the breakup of her relationship with Phil who moved to Australia soon after. Ellen is used to be filling the gaps in her life with work since then, but during the pandemic, there have hardly been any gaps to eat or sleep any more than for a few hours, let alone to socialise with friends. To start with, this had felt somewhat good as her rumination over Phil reduced gradually until work and work anxiety filled her mind. She had expected to feel awful after the vaccine, but the side effects had in fact exceeded her expectations. The shivering, the blinding headache, the cold sweats, the searing fatigue was much more than she had anticipated. Yet, she has to meet the deadline, so she has kept working round the clock. Her body gave in to sleep at about 5 am on Sunday morning, only for her to wake up at 8 am and continue relentlessly after a strong black coffee. By Sunday evening her presentation is ready and she persuades herself to have an early night, so that she can perform well the following morning when she has to deliver it. Only that her body does not obey this time and she finds herself unable to sleep. Despite her overriding anxiety and panic all goes well the following day other than the ongoing shivering and overall weakness. She finally decides to check her temperature when she is back from work. 38.9 C. Really?!


Pressure cooker effect, case study 2:


Ben is a district nurse. His job is to visit people living at home with chronic illness or disability and assess their wellbeing. Just before covid, he and his partner Louise had their first baby. It had been a relatively smooth beginning, a nondramatic birth, Louise establishing a good breastfeeding routine and finding place for him too to bond with the baby, to help out and even enjoy. As good as it gets really. And then covid struck! Who could have imagined that! Ben had already developed a sense of attachment to some of his long term patients in the two years of doing the job. But now, most of them have become unrecognisable. The number of time he has had to dial 999 in the last few months has been unprecedented and most of the time the response had been poor. Like when he found one of his older patients out of breath and turning blue. It was obvious his oxygen levels were too low and covid was the swift diagnosis Ben arrived at. Yet, when he called 999, he was told, the system was overwhelmed and younger patients had priority. He waited there patiently with him for more than an hour, but by the time the ambulance arrived, his patient was gone. This has not been an isolated incident, but an everyday reality in the last year. Ben has come to feel more like an undertaker than someone whose role is to improve people’s quality of life. A lot of the time, his task has been to report a fatal deterioration or death. Before the baby, he would go back home and confide in Louise. They would both swap notes about work and vent out. But now, increasingly, he gets back a cold shoulder or even worse, a condescending comment, that his presence is needed at home too. He cannot help, but think that Louise has become childish and self-centred since giving birth. She keeps dropping hints that he should be staying more at home with them, as though there is nothing else that matters in her little protected world. Does she even realise or care about the level of disaster, vulnerability, collapse and obliteration of life out there? He feels that it is his call of duty to put himself forward and work for even longer hours. Sometimes, when he gets to hold his son, which is less and less frequent, he has a glimpse of the intimacy and connection he felt in the early days after the birth and it feels like this was a different era, one that will never come back.

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