The emotional burden of caring for CLL patients

The Annual Conference of the Chronic Lymphocytic Leukaemia (CLL) Alliance 2026 featured a number of distinguished speakers.

In an interview with the Medical Independent at the conference, President of the Irish Haematology Society Dr Amjad Hayat touched on the emotional burden that haematologists often have to deal with. Invited guest speaker Dr Sarah Noakes (PhD), Counselling Psychologist, St George’s University Hospitals NHS Foundation Trust, London, UK, addressed this important topic in her talk, ‘When care becomes heavy: Managing emotional load in CLL.’

She discussed the “emotional load” involved in dealing with patients with CLL over time, including recognising that load, and finding practical ways to deal with it. She described CLL care as “emotionally distinct” and “a long-distance walk rather than a sprint. There are going to be periods of watch-and-wait, punctuated by moments of intensity, relapse, treatment decisions, and disease progression,” said Dr Noakes.

“As clinicians, we have to stay emotionally engaged without any clear end-point and walk along with our patients for years and years, in many cases.”

Dr Noakes presented case studies, vignettes, and posed interactive questions to the attendees on how they deal with emotional load, which could be answered via electronic audience polls. She also described the psychological processes that often create an excessive emotional load, including ‘boundary diffusion’, which involves navigating blurred lines between personal empathy and professional detachment; ‘moral distress’, which means experiencing conflict when patient care does not align with personal and ethical values; and ‘vicarious uncertainty’, when uncertainty in patient prognosis or outcomes causes
emotional strain.

Reflective or peer support is an important element of dealing with emotional load, Dr Noakes explained. It is also crucial to “acknowledge and name any uncertainties” and set realistic boundaries and expectations. 

“As clinicians, we all carry weight, but often that weight is invisible to our colleagues,” Dr Noakes concluded. “What we need to do is take that weight from being carried individually and invisibly, being absorbed without containment, to sharing it with multiple individuals who can hold that caring load. What ‘sustainable caring’ means is regulated engagement –  it’s about how you stay present, how you stay thoughtful and humane without absorbing everything that passes through each clinical encounter that we have.”