After suffering a breakdown at work, a nurse has had to confront her lifetime of damaging self-sacrifice

Often, when people are over-invested in work, they have a psychological makeup characterised by themes of self-sacrifice and abandonment of their own needs. Photograph: Johner Images/Getty Images/Johner RF

Bec* first came in for therapy for burnout. She was a psychiatric nurse and worked at a public hospital in an inpatient unit. She sobbed during our first session, full of guilt at having had to take leave after collapsing in tears during a shift. She said she was letting down her patients and team by being away. The strength of Bec’s anguish at letting people down felt disproportionate to the circumstances, and I noticed that she wasn’t concerned about her tears and collapse, just about the impact of her time off on others.

I probed deeper, trying to understand this.