Nobody warned us about the endings.

Not the dramatic ones. The quiet ones. The client who stops booking after twelve sessions. The transfer you didn't have time to process. The termination that was complete but emotionally unfinished. These endings accumulate over years — with nowhere to go.

In this episode, we go deep on the felt separation phase — the third phase of the Cycle of Caring — and why learning to inhabit it with intention may be the most neglected skill in our professional toolkit.

For the mid-career clinician who's tired in a way sleep doesn't fix. For the therapist who knows the way they've been ending things hasn't been working — but hasn't had the language for it.

What We Cover

The Cycle of Caring (Skovholt, 2005) — empathic attachment → active involvement → felt separation → recreation. The structure of our professional lives, repeated dozens of times a day. What happens when we don't attend to the full cycle.

What felt separation actually is — not just formal terminations. The ambiguous endings. The forced ones. The client who said "I think I'm good" after six sessions. What happens in us when a client walks out the door.

The inner therapist vs. what we hold — clients develop an internal representation of their therapist that carries the work forward (Rosenzweig et al., 1996). Who holds the internal representation of the client — and where does that go when the work ends?

Felt separation fatigue vs. secondary traumatic stress — two distinct mechanisms. STS is about content exposure. Felt separation fatigue is about the relational cost of attaching and letting go, over and over, without adequate processing (Figley, 2002).

Complex trauma and the weight of endings — why ordinary clinical distance activates attachment systems (Papa et al., 2024; Tanrıkulu & Gülüm, 2025). What it means to be the one who stays — while also being the one who is supposed to leave.

Premature and forced endings — the confusion, self-blame, and unresolved professional grief that accumulate when endings aren't processed (Werbart et al., 2019; Piselli et al., 2011).

Three protective factors the research supports

1. Reflective processing of endings (Thomas & Otis, 2010)
2. Intentional termination work — begin with the end in mind (Lavik et al., 2022; Chernus, 2016)
3. Structured reflective space: supervision, peer consultation, community (Stacey et al., 2020; Silverman & Segall, 2024)

Four things you can put into practice today — micro-rituals, noticing how you end sessions, bringing terminations into consultation, and naming the ending from the beginning with complex trauma clients.

Resources

• Reset Circle — Free monthly peer group. Second Tuesday, Zoom. → https://www.relitpractice.com/circle
• ReLit Practice™ — Professional development for clinicians navigating burnout and moral injury. → https://www.relitpractice.com/workwithme

Full reference list available at https://www.relitpractice.com/every-goodbye-needs-somewhere-to-go-the-felt-separation-phase--why-it-may-be-the-most-important-part-of-therapy

Episode Summary

In this episode, Stacey Steele draws on her own experience as a psychologist diagnosed with ADHD as an adult, and a growing body of research, to explore the specific intersection of neurodivergence and occupational burnout in helping professionals.

If you are currently experiencing clinical impairment or a mental health crisis, please reach out to your regulatory body’s peer support program, a trusted colleague, or a mental health professional of your own.

Stay in the conversation

The ReLit Practice 12-week program waitlist is open, enrollment begins July for the September Cohort https://www.relitpractice.com/workwithme

Before then, book a free Practice Sustainable Snapshot: https://calendly.com/relitpractice/practicesnapshot

Find Stacey at the Reset Circle each month, a free monthly peer gathering for cliniciansnhttps://www.relitpractice.com/circle

Research Referenced

• Executive function deficits mediate the link between ADHD and job burnout
• Emotional dysregulation as a core symptom of adult ADHD
• Experiences of medical students with ADHD
• ADHD in medical students and professionals — qualitative phenomenological study
• Stress and work-related mental illness among working adults with ADHD
• Strengths and challenges of ADHD in employment — systematic review
• Workplace interventions for burnout in healthcare — systematic review
• Neurodiversity in the healthcare profession
• Career sustainability and adult ADHD diagnosis
• Neurodiversity and inclusive workplaces — health disparities
• Working sustainably with ADHD or autism in the workplace
• ADHD in medical learners and physicians
• Systematic review: ADHD prevalence in medical students. (Lee & Zhang, 2025. Frontiers in Psychiatry.)

In this episode, Stacey Steele, R.Psych., takes on five of the most persistent and clinically consequential myths about burnout in the helping professions and replaces them with what the research actually shows. Drawing on recent empirical literature and honest personal experience, this episode reframes burnout as a nervous system and systemic response, not a personal failing.

Stacey distinguishes burnout from secondary traumatic stress, compassion fatigue, moral injury, and depression, and makes the case that sustainability in clinical practice requires both individual restoration and structural accountability.

Tools mentioned in the episode

The PHQ-9 and the Professional Quality of Life (ProQOL) survey for formal tracking. The Greenspace Health platform for outcome data. The Bearable app for symptom and lifestyle tracking. And for the already-tired: a Post-it on the laptop, an energy rating at the end of each day, thirty days of data.

Stay in the conversation

The ReLit Practice 12-week program opens enrollment for the September founding cohort in July, with special pricing for the first eight clinicians. https://www.relitpractice.com/workwithme

Before then, book a free Practice Sustainable Snapshot twenty minutes to look at one thing you could change this week to feel even ten percent more sustainable. https://calendly.com/relitpractice/practicesnapshot

The Reset Circle is a free monthly peer gathering for clinicians. Come once or come every month. https://www.relitpractice.com/circle

References Cited

Bianchi, R., & Schonfeld, I. (2024). Beliefs about burnout. Work & Stress, 39, 116–134.

Brindley, P., et al. (2019). Psychological ‘burnout’ in healthcare professionals. Journal of the Intensive Care Society, 20, 358–362.

Camargo, G., et al. (2021). Psychological exhaustion of nursing professionals. Revista brasileira de enfermagem, 74.

Hoffarth, M. (2017). The making of burnout. History of the Human Sciences, 30, 30–45.

Ledingham, M., et al. (2019). ‘I should have known.’ Asia Pacific Journal of Counselling and Psychotherapy, 10, 125–145.

Montgomery, A., & Maslach, C. (2019). Burnout in health professionals.

Smajlović, A., & Budler, L. (2025). Burnout and the stigma of help-seeking in nurses. Acta psychologica, 261.

Yang, Y., & Hayes, J. (2020). Causes and consequences of burnout among mental health professionals. Psychotherapy.