Burnout is a psychological term for the experience of long-term exhaustion and diminished interest. Research indicates general practitioners have the highest proportion of burnout cases; according to a recent Dutch study in Psychological Reports, no less than 40% of these experienced high levels of burnout. Burnout is not a recognized disorder in the DSM although it is recognized in the ICD-10 as “Problems related to life-management difficulty”.
The most well-studied measurement of burnout in the literature is the Maslach Burnout Inventory. Maslach and her colleague Jackson first identified the construct “burnout” in the 1970s, and developed a measure that weighs the effects of emotional exhaustion and reduced sense of personal accomplishment. This indicator has become the standard tool for measuring burnout in research on the syndrome. The Maslach Burnout Inventory uses a three dimensional description of exhaustion, cynicism, and inefficacy. Some researchers and practitioners have argued for an “exhaustion only” model that sees that symptom as the hallmark of burnout.
Maslach and her colleague, Michael Leiter, defined the antithesis of burnout as engagement. Engagement is characterized by energy, involvement and efficacy, the opposites of exhaustion, cynicism and inefficacy.
Many theories of burnout include negative outcomes related to burnout, including job function (performance, output, etc.), health related outcomes (increases in stress hormones, coronary heart disease, circulatory issues) and mental health problems (depression, etc.).
The term burnout in psychology was coined by Herbert Freudenberger in his 1974 Staff burnout, presumably based on the 1960 novel A Burnt-Out Case by Graham Greene, which describes a protagonist suffering from burnout.
Organizational burnout
Tracy in her study aboard cruise ships describes this as “a general wearing out or alienation from the pressures of work” (Tracy, 2000 p. 6) “Understanding burnout to be personal and private is problematic when it functions to disregard the ways burnout is largely an organizational issue caused by long hours, little down time, and continual peer, customer, and superior surveillance”.
How the stress is processed determines how much stress is felt and how close the person is to burnout. One individual can experience few stressors, but be unable to process the stress well and thus experience burnout. Another person, however, can experience a significant amount of stressors, but process each well, and avoid burnout. How close a person is to a state of burnout can be determined through various tests.
Phases
Psychologists Herbert Freudenberger and Gail North have theorized that the burnout process can be divided into 12 phases, which are not necessarily followed sequentially, nor necessarily in any sense be relevant or exist other than as an abstract construct.
The Compulsion to Prove Oneself
Often found at the beginning is excessive ambition. This is ones desire to prove themselves while at the workplace. This desire turns into determination and compulsion. This leads them to show off to their co-workers, proving that they are doing an amazing job, that they are doing better than all others.
Working Harder
Because they have to prove themselves to others, people establish high personal expectations. In order to meet these expectations, they tend to focus only on work while they take on more work than they usually would. With their main focus on work, they become obsessed with doing everything themselves. This will show that they are irreplaceable since they are able to do so much work without enlisting in the help of others.
Neglecting Their Needs
Since they have devoted everything to work, they now have no time for anything else. Friends and family, eating, and sleeping start to become unnecessary or unimportant. In order to make themselves feel better about neglecting necessities, they tell themselves that these are just sacrifices that will prove that they are the best.
Displacement of Conflicts
Now, the person has become aware that what they are doing is not right, but they are unable to see the source of the problem. In order to deal with the root cause of this could lead to a crisis in themselves and become threatening. This is when the first physical symptoms are expressed.
Revision of Values
In this stage, people isolate themselves from others, they avoid conflicts, and fall into a state of denial towards their basic physical needs begin to change their perceptions. They also look at their value systems and friends/hobbies are no longer important. Their new value system is their job and start to be emotionally blunt.
Denial of Emerging Problems
Now seeing their coworkers as dumb, lazy, and demanding of them, the person begins to become intolerant. They don’t like being social, and if they were to have social contact, it would be merely unbearable. Outsiders tend to see more aggression and sarcasm. The person blames their increasing problems on time pressure and all they work that they have to do, but they do not blame their problems on the ways that they have changed, themselves.
Withdrawal
Their Social contact is now a minimum, soon turning into isolation, a wall. Alcohol or drugs may be sought out for a release since they are obsessively working “by the book”. Their feelings of that of being without hope and no direction.
Obvious Behavioral Changes
Coworkers, family, friends, and other people that are in their immediate social circles cannot overlook the behavioral changes of this person. The people in the social circles have become apathetic, fearful, and shy.
Depersonalization
Losing contact with themselves, they no longer see themselves or others as valuable. They no longer see personal needs. Their view of life narrows to only seeing in the present time, while their life turns to a series of mechanical functions.
Inner Emptiness
They are empty inside and to overcome this, they look for activity such as sex, alcohol, or drugs. These activities are exaggerated and overreacted. They start to think that their leisure time is dead time.
Depression
Burnout and depression easily correspond. The person is becoming exhausted, hopeless, indifferent, and believe that there is nothing for them in the future. To them, there is no meaning of life. Typical depression symptoms arise.
Burnout Syndrome
Suicidal thoughts have passed through the minds of these people to use as an escape from their situation and only few people will actually commit suicide. They collapse physically and emotionally and should seek immediate medical attention.
Preventing burnout
While individuals can cope with the symptoms of burnout, the only way to truly prevent burnout is through a combination of organizational change and education for the individual. Organizations address these issues through their own management development, but often they engage external consultants to assist them in establishing new policies and practices supporting a healthier worklife. Maslach and Leiter postulated that burnout occurs when there is a disconnect between the organization and the individual with regard to what they called the six areas of work life: workload, control, reward, community, fairness, and values. Resolving these discrepancies requires integrated action on the part of both the individual and the organization. A better connection on workload means assuring adequate resources to meet demands as well as work/life balances that encourage employees to revitalize their energy. A better connection on values means clear organizational values to which employees can feel committed. A better connection on community means supportive leadership and relationships with colleagues rather than discord.
One approach for addressing these discrepancies focuses specifically on the fairness area. In one study employees met weekly to discuss and attempt to resolve perceived inequities in their job. This study revealed decreases in the exhaustion component over time but did not affect cynicism or inefficacy indicating that a broader approach is required.
Coping with burnout
There are a variety of ways that both individuals and organizations can deal with burnout. In his book, Managing stress: Emotion and power at work (1995), Newton argues that many of the remedies related to burnout are motivated not from an employee’s perspective, but from the organization’s perspective. Despite that, if there are benefits to coping strategies, then it would follow that both organizations and individuals should attempt to adopt some burnout coping strategies. Below are some of the more common strategies for dealing with burnout.
Organizational aspects
Employee assistance programs (EAP)
Stemming from Mayo’s Hawthorne Studies, Employee Assistance Programs were designed to assist employees in dealing with the primary causes of stress. Some programs included counseling and psychological services for employees. There are organizations that still utilize EAPs today, but the popularity has diminished substantially because of the advent of stress management training (SMT).
Stress management training
Stress Management Training (SMT) is employed by many organizations today as a way to get employees to either work through stress or to manage their stress levels; to maintain stress levels below that which might lead to higher instances of burnout.
Stress interventions
Research has been conducted that links certain interventions, such as narrative writing or topic-specific training to reductions in physiological and psychological stress.
Individual aspects
Problem-based coping
On an individual basis, employees can cope with the problems related to burnout and stress by focusing on the causes of their stress. This type of coping has successfully been linked to reductions in individual stress.
Appraisal-based coping
Appraisal-based coping strategies deal with individual interpretations of what is and is not a stress inducing activity. There have been mixed findings related to the effectiveness of appraisal-based coping strategies.
Social support
Social support has been seen as one of the largest predictors toward a reduction in burnout and stress for workers. Creating an organizationally-supportive environment as well as ensuring that employees have supportive work environments do mediate the negative aspects of burnout and stress.