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As a young newly qualified social worker I vividly recall an encounter with an isolated single parent who had recently moved into the neighbourhood in which I worked. If memory serves me well, her husband had recently abandoned her after they had arrived in England from Eastern Europe. She understood little about how our welfare system worked and was clearly extremely emotionally vulnerable. In my first contact with her I felt able to help her in a number of ways, including recognising and taking in some of her emotional distress and, given her predicament, we parted on comfortable terms. When we next met she asked me to do something - I think to accompany her to the local social security office - which I felt to be slightly beyond the boundary of my professional role. So I declined her request. The woman exploded with fury, disappointment and hurt, a barrage of powerful feeling which she sustained for several minutes until she walked out of the office saying, “I thought you were going to be my friend”. I was devastated by her reaction, and suffered two or three days of guilt, self-doubt, and emotional bewilderment. My professional and personal narcissism (if it is possible properly to distinguish the two) was severely injured, and my idealisations of myself as a helpful and caring professional had taken a significant knock. Phantasies of myself as a heroic rescuer of the vulnerable and dispossessed (phantasies I certainly had) would need to be modified. The hand which feeds had been nastily bitten.
I found Stijn Vanheule's paper ‘Caring and its Impossibilities’ an original and thought-provoking contribution to the very limited psychoanalytic literature on professional burnout. Lacanian thinking