Book Review

The Resilient Clinician

N Engl J Med 2008; 358:1414-1415March 27, 2008

Article

The Resilient Clinician
By Robert J. Wicks. 255 pp. New York, Oxford University Press, 2008. $29.95. ISBN: 978-0-19-531697-1

Countless books on how to be a psychotherapist include sections on coping with stress and burnout, and there exists a growing literature that is completely devoted to this modern affliction. One might reasonably wonder whether there is a need for yet another book on therapist burnout. The answer is, quite simply, yes. Robert Wicks's The Resilient Clinician is a short and powerful guidebook aimed at a specific population of therapists: those spiritual travelers who employ concepts such as mindfulness and who practice positive psychology. For this substantial and increasing readership, Wicks's most recent work becomes a poetic aid for coping with stress, vicarious post-traumatic stress disorder, and burnout.

This guide, from its viewpoint of positive psychology, presents many unconventional solutions. Wicks directs therapists' energy toward increasing their strengths, rather than reducing or eliminating their weaknesses, and the book is therefore an important addition to the self-help literature on burnout. Wicks clearly understands that psychotherapy has a bias toward the negative; it is concerned with discovering what is wrong with the client's world and then fixing it. Experienced therapists know that they must fight against the pessimism of diagnosis and the discouragement that comes from the slowness of change. The Resilient Clinician consistently directs us to concentrate on our strengths and on the numerous positive aspects of our profession — teaching us how to thrive instead of merely survive.

Every therapist is familiar with the litany of problems we face in our profession: we see difficult clients, we and others cling to unrealistic expectations, endless pointless reports pile up in our hard drives, there are too few resources, and we have too little time for ourselves or for the emotional processing we must do to maintain a balanced practice, let alone nourish a thriving and fruitful one. All of these problems contribute to stress and burnout. Wicks moves us beyond this. He emphasizes the joy that can be found in helping and the things that drew the practitioner to the vocation in the first place. He also succinctly outlines successful methods of stress reduction and management, but this is not at the core of the book.

The central path of the book begins with an impressive self-assessment test of both vulnerability to stress and indications of vicarious post-traumatic stress disorder. Enough trauma around us can insidiously become trauma within us. Both evaluations are thought provoking and move readers toward a fresh experience of mindfulness. Each subsequent chapter ends with a practicum and probing questions for further reflection. The rest of the book gives the reader many methods for establishing a self-care protocol that Wicks hopes will become a daily practice, similar to yoga or meditation. The enormous benefits of this protocol, including efficiency and enthusiasm, more than make up for the time that will be spent creating it.

Wicks emphasizes the development of resilience. He teaches us how to bounce back to enthusiasm and rediscover a sense of meaning. Rather than being told to “heal thyself,” we discover how to “rebound.” This ability to handle stress and trauma becomes a learning experience that strengthens us, and that is the invaluable gift of The Resilient Clinician.

Obviously an experienced mentor of therapists, Wicks knows that the single greatest barrier to achieving resiliency is that our modern lives are defined by busyness. Psychotherapists, as creatures of the contemporary age, almost universally declare that they are too busy to follow a new program, even if it means deliverance from the twin culprits of stress and burnout. Yet Wicks's many simple and minimally time-consuming exercises can begin to create and strengthen constructive and healing habits. This short and profound treatise is interesting to read, but Wicks moves beyond providing insight, urging the reader to act. Inspiring the reader to take action is Wicks's goal and the book's real purpose.

John V. Flowers, Ph.D.
Chapman University, Orange, CA 92866
flowers@chapman.edu