When the Inside Screams: New Perspectives on What Really Helps

## Introduction When we talk about someone 'hitting the wall', many people automatically think of work: too much responsibility, too many hours, too-high demands. But what if the cause often lies elsewhere? According to Aftenposten, recent research shows that burnout is often caused by factors other than work. In the feature we meet Bendik (32), who 'doesn't believe his job was the main reason he hit the wall', and we read 'the mental coach's advice for avoiding burnout' (Aftenposten, 24 May 2025). This shifts the narrative around treatment and prevention of mental health problems. In this opinion-style article I will use that insight as a springboard to discuss different forms of psychotherapy and treatment — from established methods like cognitive behavioral therapy and group therapy, to newer, controversial approaches such as psychedelic-assisted therapy — and, importantly, why a somewhat 'selfish' approach to choosing treatment may be necessary to achieve real improvement. This review is intended as a fact-based, nuanced and practical guide for both professionals and general readers who want to understand which types of therapy may be most appropriate in different situations. I will explicitly refer to findings reported in Aftenposten to anchor the discussion in a current national context. The goal is to give you tools to evaluate treatment options, ask better questions, and — if necessary — take a more active role in your own care. ## What the study and the feature say: more than work alone According to Aftenposten, a surprising finding is that many who experience burnout do not necessarily have work as the primary cause. The feature states that 'Bendik (32) doesn't believe his job was the main reason he hit the wall', and the article relays the mental coach's advice for avoiding burnout (Aftenposten, 24 May 2025). This perspective challenges a linear causation model where work-related factors alone explain exhaustion and emotional collapse. When studies and journalism point to multiple causal factors — for example personal relationships, underlying mental health issues, trauma, sleep and lifestyle factors — both prevention strategies and the treatment repertoire that should be considered change. It is important to emphasize that this nuance does not absolve the workplace of responsibility. Job stress can be a significant trigger, and the work environment can worsen or maintain problems. Still, it clearly means that many who experience burnout need a holistic assessment that goes beyond adjustments to working hours or tasks. This requires broader diagnostics and a treatment focus that includes psychotherapy tailored to the underlying issues, rather than a standardized 'rest and holiday' approach. ## Overview of psychotherapy types: traditional and new When choosing treatment, knowledge about different forms of psychotherapy is essential. Below is a review of the most relevant methods, focusing on what research and clinical experience say about the problems they are suited to treat. ### Cognitive Behavioral Therapy (CBT) Cognitive behavioral therapy is one of the most well-documented psychotherapies and works well for anxiety disorders, depression and stress-related complaints. CBT is based on the idea that thoughts, feelings and behaviors are closely linked, and that change in one area can affect the whole. Therapy is often structured, goal-oriented and time-limited, which makes it well suited for people who want concrete tools to manage symptoms. In the context of burnout, as Aftenposten describes, CBT can be useful for challenging negative thought patterns, establishing better sleep routines and gradually building coping strategies. Still, CBT can be too shallow if there are underlying traumas or long-standing relational difficulties. Therefore, treatment choices should always be based on a thorough assessment. ### Psychodynamic therapy Psychodynamic therapy focuses on unconscious processes, early relationship experiences and how these affect current functioning. The therapy can be less structured and more exploratory than CBT. For people whose burnout is linked to long-term relational patterns, identity issues or early burdens, psychodynamic therapy can provide deeper insight and lasting change. Treatment length varies, but this form of therapy may be necessary to resolve complex, chronic problems that do not respond well to short-term interventions. This brings up the question of investment — both in time and money — and the patient's 'selfishness' in prioritizing their own treatment becomes a relevant ethical and practical issue. ### Group therapy Group therapy is an effective treatment for many disorders and has unique advantages: support from others, the opportunity to practice social skills, and mutual mirroring. Clinical experience shows group therapy works particularly well for personality difficulties, grief processing and reducing isolation, which often accompany burnout and depression. Group offerings can also be more affordable compared with individual therapy, and provide an arena to work on relational skills in a safe setting. Challenges can include group dynamics and the need for skilled facilitation. For many, group therapy is an essential part of a comprehensive treatment plan, but it should be combined with individual follow-up when deep-seated problems are uncovered. ### Focused therapies (e.g., EMDR and brief focused methods) Focused therapies such as EMDR (Eye Movement Desensitization and Reprocessing) and other trauma-specific methods are designed to target and treat specific traumatic memories or particular symptom burdens. These methods can provide rapid symptom relief when appropriately indicated, and they are increasingly used in national practice. In light of Aftenposten's emphasis on non-work-related causes of burnout, it is relevant to consider whether underlying trauma or specific burdens require this type of focused intervention. Where traditional talk therapy may take months or years to reach the core, focused methods can deliver noticeable improvement in a shorter time when properly applied. ### Psychedelic-assisted therapy: opportunities and cautions Psychedelic-assisted therapy — therapy that combines psychedelic substances (such as psilocybin or MDMA) with psychotherapeutic support — has gained international attention in recent years due to promising research results for treatment-resistant depression, PTSD and severe anxiety. This approach differs radically from traditional methods: the substances can open states in which the patient experiences deep insights, emotional breakthroughs, and altered self-perception. However, it is important to be both enthusiastic and cautious. Psychedelic-assisted therapy requires strict protocols, qualified therapists, careful participant selection, and close follow-up after sessions. Risks include the triggering of psychosis in vulnerable individuals, and the incomplete integration of the experience without adequate therapeutic support. In addition, there are legal and ethical barriers in many countries. For Norway, this means such offerings are still in an early phase, and patients must be critical and well informed before considering participation in trials or private offers abroad. But the possibilities are real: for some patients with entrenched symptoms and previous treatment failures, psychedelic-assisted therapy may be a 'last resort' with potentially large clinical gains. Decisions here must be characterized by thorough assessment and the patient's active involvement in choosing the treatment path. ## Self-prioritization in treatment: why it's necessary to be a little 'self-centered' When Aftenposten and other media point out that burnout often isn't primarily caused by the job, the question becomes: who has the responsibility to initiate the right treatment? My answer is that the patient must take greater ownership — that is, a certain degree of 'self-prioritization' or 'selfishness' — to put their own health first. By 'selfishness' I do not mean negative self-centeredness, but a conscious and responsible prioritization of one's own needs, boundary-setting, and willingness to choose treatments that actually address the root causes. This can involve difficult choices: taking time off work, saying no to family obligations temporarily, or investing financially in therapy. For many, it is taboo to spend time and resources on themselves, especially in a culture that glorifies productivity. Still, it is a well-known truth that treatment that does not get time or continuity often fails. Therefore both patients and clinicians must be clear about what is required for therapy to be effective — and the patient must be willing to prioritize this. Self-prioritization in treatment also means being selective. Some patients remain in therapeutic courses that do not work — perhaps because it's easier than seeking a new option, or because they feel loyalty to the therapist. Changing therapists, or combining different treatment approaches (for example individual CBT + group therapy or focused EMDR + psychodynamic work) can often lead to real improvement. The patient's active role is decisive here. ## How to combine treatments in practice: concrete examples Practical treatment often involves combination approaches. A typical example might be a person with burnout who, according to Aftenposten's feature, does not find a single main cause in work, but experiences chronic sleep problems, conflicts in close relationships and depressive symptoms. An appropriate plan could include the following components: - Short-term CBT to achieve rapid symptom relief, structure and tools for sleep and stress management. - Couples or family sessions to address relational burdens that maintain stress. - EMDR or other focused trauma treatment if specific traumas are uncovered. - Group therapy for social support and continued work on coping strategies. - Close follow-up from the GP and a psychiatrist if medication support is needed. This example shows that it is rarely a single therapy that is 'right'. Broad assessment and interdisciplinary collaboration give the best chance of lasting improvement. At the same time, this requires the patient to make an active choice, and in practice often requires the employer or family to contribute so the patient has time and space to follow the treatment plan. ## Risks, availability and ethical considerations When discussing new treatments such as psychedelic-assisted therapy, we must also take ethical and safety aspects into account. Treatment availability is a challenge: waiting lists for public mental health services, regional differences in access, and the costs of private treatment mean many patients end up with inadequate follow-up. For patients considering psychedelic approaches abroad, it is essential to ensure clinical competence, protocol-based practice, and post-treatment follow-up. Moreover, good treatment requires informed consent — patients must receive an honest review of expected effects, risks and alternatives. This applies whether the treatment is CBT, EMDR or psychedelic therapy. Clinicians must avoid overoptimistic portrayals, especially when media coverage can inflate hope. Accessibility and fair distribution are also central societal questions. Should breakthrough treatments be prioritized for a few who can afford them, or should measures be taken to include more people through public funding and research? The answer lies in political choices and health-care priorities. ## Practical advice for patients and relatives Based on insights from Aftenposten's feature and knowledge of treatment forms, here are some concrete tips for those considering psychotherapy or treatment: 1. Ask for a thorough assessment: Request an evaluation that goes beyond work-related stress — look for trauma, sleep problems, relational conflicts and underlying mental health issues. 2. Be 'selfish' about treatment: Prioritize time, money and energy on therapeutic measures that are likely to be effective — don't stay loyal to a treatment that isn't working. 3. Consider combinations: Many get the best results when short-term and long-term methods are combined, or when individual therapy is supplemented with group therapy. 4. Ask about evidence and risks: This is especially important for experimental or new methods like psychedelic therapy. 5. Involve your GP and, if needed, a multidisciplinary team: Coordination can prevent mistreatment and ensure comprehensive follow-up. ## Conclusion: Treatment requires both knowledge and courage That burnout is often caused by things other than work, as highlighted in Aftenposten's feature where Bendik (32) among others does not believe his job was the main reason he 'hit the wall', shows that we must think more broadly about causes and treatment (Aftenposten, 24 May 2025). This places demands on both patients and clinicians: treatment must be individualized, flexible and sometimes brave enough to try new or combined approaches. The landscape of psychotherapy offers many possibilities — from effective, structured CBT, through group therapy and focused trauma treatment, to potentially transformative psychedelic-assisted therapy. But regardless of choice, the patient must be willing to prioritize their health. A responsible form of 'selfishness' in treatment choices can be the difference between temporary symptom relief and lasting recovery. As a society we must also consider how to make good treatment options more accessible and ensure that promising new treatments are thoroughly investigated and responsibly implemented. In the meantime, it is important that individuals receive knowledge, support and space to choose treatments that go deep — not just patch over symptoms. ## Sources - Aftenposten: "Burnout is often caused by other things than work, study shows." Date: 2025-08-07 / feature published 24 May 2025. URL: https://www.aftenposten.no/karriere/i/Xj1kQr/utbrenthet-skyldes-ofte-andre-ting-enn-jobb-viser-studie (Article refers to the quote: 'Bendik (32) doesn't believe his job was the main reason he hit the wall. Here is the mental coach's advice to avoid burnout.')