Have you ever been on a job and found that your tolerance for frustration had really begun to ebb? Are you starting to snap at your co-workers, maybe also having difficulty concentrating? Are you feeling trapped while at the same time feeling like your department couldn't get along without you? Does this contribute to a feeling that you simply cannot go on vacation, even though you feel the extreme need for one, and does the whole thing make your stomach tie up in a knot? Is there a lack of people to talk to about it because all the people you know and trust have been leaving the company? These are just a few of the signs of what is commonly known as "burnout." And because it is something that happens gradually over time, many of us don't notice it until it has become a physical and emotional strain that is detrimental to our mental and physical health.
So what is burnout and what causes it? Who does it happen to? Is it a defect in our character or is it something that can happen to anyone? "Burnout is a state of physical, emotional and mental exhaustion. It is the result of repeated emotional pressures, often associated with intense involvement with people over long periods" (Pines & Aronson, with Kafry, 1981; as cited in Corey, Corey & Callanan, 1993, p.50). "Burnout is the depletion of physical and mental resources characterized by a loss of motivation, enthusiasm, energy, and interest, as well as a significantly lower level of performance" (Kyriacou & Sutcliff, 1978; as cited in Peterson & Nisenholz, 1995, p.30). "To become exhausted, especially as a result of overwork or dissipation" (The American Heritage Dictionary, 1980, p.178).
To summarize, burnout is a state of feeling like you simply have no more to give. This does not necessarily only mean no more to give to your job. It can mean no more to give to your job, your family, your friends, your personal life, and your own growth. It is a sense of being a reservoir that has been overtapped, that is simply not bringing in fresh water from its springs as quickly as the water is being taken out by the environment that it is serving. And human beings, truly like reservoirs, only have so much they can give before what they are giving becomes a health risk both for themselves and often for those who are on the receiving end, because those around us are also affected by our depletion and subsequent burnout in adverse ways.
Burnout takes place over time. In the newsletter Update on Human Behavior, burnout is defined as containing the following stages: 1. The Honeymoon Phase. During this phase, much of the job is new and "energy level and enthusiasm are high." We enjoy our jobs and are satisfied with the challenges. 2. Disillusionment. We begin to understand that this job is not the one that will meet all our needs. "[Your] expectations have been unrealistic." "[You] have a vague sense that something isn't right without being able to identify exactly what it is. You try even harder to reach your goals, but end up feeling bored, frustrated and lacking in self-confidence." 3. Brownout. "[This stage is] characterized by fatigue, irritability, sleep disturbances, changes in eating patterns and possibly escapist drinking or shopping binges." 4. Frustration. "[This stage is] marked by anger, loss of enthusiasm, cynicism, detachment, and physical illness." 5. Despair. "You feel a tremendous sense of failure; pessimism, self-doubt, loneliness, and emptiness are also typical. People in this stage often talk of wanting to 'run away' and abdicate responsibilities; physical illness may become incapacitating" (Kelley, 1992, p.2).
What is the cause of burnout? Is it only job related? Can we burnout on our relationships or our family life? What tells us that we or someone we know is burning out? There are many causes to burnout and we will look at some of them here.
One of the leading causes of burnout in the human service professions, and for mental health workers especially (my particular field of interest), is striving for perfection in all that we do. Setting high, lofty goals that are simply unreasonable is common in the human service professions where we tend to invest so much of who we are in the health and betterment of our clients. "This leads to a vicious cycle of frustration: the more accomplished, the more that remains to be accomplished" (Peterson and Nisenholz, 1995, p.34). Many of us assume a high correlation between our success at work and our self-esteem and self-worth. How can we be worth anything if we can't do even more for our clients, if we can't be perfect? "As with academic striving, counselors must differentiate between self-defeating perfectionism and the healthy pursuit of excellence" (Peterson and Nisenholz, 1995, p.34).
But it is not just ourselves who place unreasonable demands on our time, resources and emotional resilience. Often it is a supervisor or manager who places such demands on us, simply requesting too much. Maybe there are too many cases and not enough staff. The manager and/or supervisor may also be experiencing a common phenomenon of today's human services workplace - a shrinking budget and a growing caseload.
Whatever the reason, they've always been able to count on you before and, being thoroughly swamped with work themselves, they do not see the caseload with which you are already burdened and struggling. They may be simply handing out the work and expecting it to be done. If they are perfectionists themselves, they may expect no less from those who work with them, an unrealistic goal. The "good" worker, whether because of the need to feel confident of his/her ability, to feel needed or to please the boss, or simply for fear of losing his/her job, takes on the work even though he/she is already stretched to the limit. This is a sure road to burnout.
As we can see, the need to know one's limits in the human services fields, as well as in others, is a must. We each can do only so much. We need to learn when we are pushing ourselves to the limits of our cognitive, physical and emotional strength and be willing to accept ourselves for who and what we are - well meaning intelligent people who cannot save the world.
Are there other things that might lead to burnout? There are too many to list, but here are some: "Employees feeling under-utilized or unchallenged by their work, frequent interruptions or changes in work priorities, lack of recognition for work, unclear job descriptions, limited upward mobility, or inadequate rewards or incentives for above-average performance" (Kelley, 1992, p.2).
Often when people feel they are not being used to their fullest potential at a job, they begin to resent the situation and feel stuck. This can contribute to lack of self-esteem. In the workplace, it can contribute to work not done up to standard and to work not being done on time. Unchallenging work can lead to extreme boredom and laziness, again contributing to the above conditions. Retaining the quality of our work and keeping with deadlines can produce resentment when our work goes unrecognized and unrewarded. Also, when we are frequently asked to change our priorities at work, often leaving multiple tasks unfinished in the need to apply greater time to a new priority, we may see our work as meaningless. People need a sense of completion, of closure, to the tasks they take on. With so many strings left dangling, we can feel disorganized and confused (Kelley, 1992, p.2).
In the paper Making Family Therapy Easier For The Therapist: Burnout Prevention, by Robert Friedman, Ph.D., another cause of burnout is lack of clarity concerning what one's level of responsibility is. He states, "I believe the major responsibility for positive change rests with the family, not the therapist and that the problem belongs to the family, not the therapist. The therapist is responsible for serving as a catalyst, providing a setting for growth and change, and is not responsible for rescuing the family from pain and suffering" (p.5).
The human services worker who takes on the burden of doing all of the client's work is sure to become burned out. Knowing your level of responsibility is a must in any field that deals with the public regularly. It is also good to know your responsibility in your personal relationships and be open to discussing the changing roles and levels of responsibility in personal and professional relationships. Are there facets of personality that might lead to burnout? Yes, there are. People who lack flexibility, who can only see one way to do something and may continue to do the same thing over and over again even after consistent failure will often burnout. Some people get "success fever," the fear of succeeding, and find ways to sabotage themselves. This is not necessarily conscious sabotage, but sabotage nonetheless. Conversely, the fear of failure can keep one from thinking differently about a situation, from being creative. Tasks can become repetitive and the beginnings of burnout can seep in (Kelley, 1992). Type A personalities appear to be more vulnerable to ailments related to stress, and therefore, to burnout, too. Peterson and Nisenholz (1995) list the type A personality as, "[containing] a high degree of such traits as self-control, impatience, time urgency, aggressiveness, tenseness, inability to relax, achievement orientation and insecure status" (p.30).
Who gets burnout? Burnout can happen to anyone. "The question, then, is not who will experience burnout but how long the next episode will last. It is the nature of the human condition in general, and the therapist condition in particular, to experience ebbs and flows in life satisfaction" (Kottler, 1993, p.157). "22% of workers 22-34 years old complain of burnout; but in the 35-46 year old group, 64% felt burned out" (Kelley, 1992, p.1).
Are people in certain types of jobs more susceptible to burnout? "Jobs requiring heavy people contact (teachers, salespeople, airlines personnel); heavy responsibility for others (lawyers, physicians, the helping professions), extremely repetitive monotonous work (assembly line workers, data entry clerks), or deadline work (paralegals, journalists), have a higher burnout potential than other fields" (Kelley, 1992, p.1). As you can see from the numbers stated above and the list of occupations, just about anyone is susceptible to burnout. A good occupation is not just an occupation that pays well. It needs to stimulate and sustain us in many different ways, not just in earning potential.
But why is it that not everyone burns out? Can we recognize symptoms of burnout early on and are there ways to head it off? Yes we can and yes there are. Jeffrey A. Kottler (1993, p.159-162), in his book On Being a Therapist, states these common symptoms of burnout as early warning signs of burnout: "There is a resistance to call the office or answering service for messages and a resistance to returning calls." Every phone call brings with it a sense of foreboding, a sense of 'Oh god, what now?' "When a client calls to cancel, the therapist celebrates with a bit too much enthusiasm. Dancing and singing in the hallway is a dangerous sign of advanced deterioration." This one needs no clarification.
"Daydreaming and escapist fantasy are common." How can you still be enjoying your job when you are consistently dreaming of being somewhere else? "The alarm clock is less a signal to begin the day than an order to resume one's sentence." Each wake up call seems like the sheriff calling to return us to prison.
"As in all instances of prolonged stress, therapists are prone to anesthetizing themselves with self-prescribed medications." Also, for therapists and those of us without access to prescription medications, alcohol and illegal substances provide the necessary anesthetizing affect. "During leisure time there is a distinct preference for passive entertainment." Often the TV set becomes much more interesting than the bicycle or a walk in the park, especially if you have anesthetized yourself.
All of these things can have a detrimental emotional and physical affect on you and those around you. Time for your family may become a burden in your need to "veg out" on the couch. You may not have the energy to play with your kids or focus attention on your spouse, or you may find you become quick to anger with both. You may not make the time for you and your spouse to go out for dinner or see friends.
As your world shrinks around you, so can your self-esteem, which causes your world to shrink more, which decreases your self esteem, etc., etc., etc. As you get less and less exercise, physical ailments such as lower back pain, a general lack of energy and frequent headaches can occur. The tenseness in your muscles, when not released in daily recreative activity, can build up and produce all the above stated ailments. These signs need to be watched for before the ailments become severe.
Are there ways to reverse the process or even prevent it? Yes to both. There are many things we can do. Burnout prevention can be started right away by anyone. Reversal of the process is often much harder for many of us. Few people wish to admit they are burning or have burnt out. It is often seen as a weakness and something to be defeated by simply working harder. This generally just deepens our descent into the mire of burnout. Both Kottler (1993) and Kelley (1992) state denial as one of the largest hurdles, if not the largest, in recovery from burnout.
Enlisting the help of friends and learning to listen to colleagues is a good first step in recovery. When people are frequently concerned for the state of your emotional and physical health, it is time to check in with yourself. Burnout is not a weakness. It can happen to anyone when they are pushed passed their limits. Kelley (1992) states that one should, "Accept your negative feelings of anger, confusion, depression, anxiety and failure as a normal part of the burnout process and as a necessary step to recovery." As the next step he states, "Something emotional dies during the burnout process. Whether it's an identity, idealism, or a dream, there's a powerful sense of loss and you must allow yourself time to mourn its passing. (p.3)"
Both Kelley (1992) and Kottler (1993) recommend talking to people - friends, family, or colleagues - about your feelings. Talking helps to alleviate the pain that these feelings cause and, therefore, decrease the power they wield over us. Professional help, going to therapy, is also a good way to help refocus our goals in a constructive and healthful way. Talking about our feelings is a major step towards better mental health in general. It is both a recuperative and preventive measure. So it is always a good skill to learn.
There are many things that work in both the recuperative process and preventive programs. Here are a number of them. Doing things differently can create a different feel for the day. When we fall into a rigid schedule of always doing the same projects at the same time, work becomes repetitive. Rearrange your schedule a little bit. See what can fit where and alter it every few weeks. Also, doing particular projects a little differently can breath fresh life into them. If you feel stuck and cannot think of another way to do something, ask a colleague or friend how they would tackle it, or find information on how others have handled the type of work you do and try it (Kottler, 1993).
Setting limits for yourself is important. Know when there is too much work and seek help or recognize when you need to stop for the day. Don't skip lunch. Don't skip breaks. People who are burnt out need to make sure they appropriate time for relaxation and then find something they truly enjoy doing with that time, not just fill it with the television. Meditate, ride a bike, go for a walk, read a book, climb a tree, sing, play an instrument or work in a garden. Horticulture therapy is a little known but well documented source of relaxation and a great self-esteem builder. Whatever you do with the time, make it something you enjoy and make sure you do it (Kottler, 1993; Kelley, 1992; Brill, 1990; Peterson & Nisenholz, 1995)
Kottler (1993) recommends teaching. "When you explain to others what you do, how you do it, and why you do it a particular way, you are forced to think through the rationale for every intervention." "[This process] gives greater meaning to your clinical work" (p.171). "To teach is to continually evaluate what we do from the perspective of an innocent" (p.173).
Brill (1990) says that going to seminars and workshops is a great way to revitalize yourself and bring fresh ideas to your work. This goes along with the idea of doing things in new and different ways. This writer personally knows of one teacher he has had who, when asked why she decided to use a certain model of therapy with a particular client, stated laughingly, "Well, true to form, I had just come back from a seminar on narrative therapy and...." New ideas are sometimes intimidating. But if we view the newness as a fresh environment to be explored, a challenge instead of a dark alley that one must pass through, we learn and grow. This can bring us back to work the following day with ideas of how to do things even better and with a new-found energy for our work.
Proper exercise and nutrition are often dismissed in importance as we rush to get our work done, yet they hold the key to physical wellness. Mental wellness is generally not probable without physical wellness. This writer gets incredibly grouchy when he hasn't eaten properly during the day. And proper exercise, just walking for an hour, can release mountains of stress and worry into the air, leaving us feeling relieved and refreshed, ready to return to our work or homes (Peterson & Nisenholz, 1995).
Peterson and Nisenholz (1995) use the acronym "BE NATURAL" for their "stress management plan" (p.37-42) It stands for breathing, exercise, nutrition, attitude, time management (setting priorities), uniqueness, relaxation, associations (support system), and laughter. It is the most detailed plan I have found yet for preventing burnout and creating growth.
Burnout can happen to anyone in any profession or situation. It knows no boundaries of race, sex, economic status, employment status, or cognitive ability. Burnout can be debilitating to us both physically and emotionally, possibly causing exhaustion and withdrawal from the world around us. It impacts us slowly, creeping up on us almost imperceptibly at first, with devastating results when left unchecked. It affects our job relations as well as our family relations.
Burnout is preventable and can be recovered from. It is incumbent upon us all to learn to recognize the symptoms and to learn to realize when the specter of denial has raised its ugly head. It is also incumbent upon us to help our friends and relations recognize it in themselves and to be supportive as we would wish to be supported in return. Dealing with burnout is much tougher when done alone. The spirit of a supportive environment helps us regain our natural selves and decreases the feelings of isolation that can drive us there to begin with.