What is Burn-out Syndrome?
Burn-out as a work-related disease is on the rise. Not only in the Western world but increasingly in Asian countries as well.
But only a few years ago it was finally acknowledged as a real medical condition in the DSM 5 ( The handbook of Psychiatric symptoms).
Burn-out is defined in ICD-11 as follows: (ICD-11 is the handbook of medical conditions that is used primarily by physicians)
“Burn-out is a syndrome conceptualized as resulting from chronic workplace stress that has not been successfully managed. It is characterized by three dimensions:
- feelings of energy depletion or exhaustion;
- increased mental distance from one’s job, or feelings of negativism or cynicism related to one’s job; and
- reduced professional efficacy.
Burn-out refers specifically to phenomena in the occupational context and should not be applied to describe experiences in other areas of life.”
But this is actually only the finale state- and the energy depletion is not only mentally but also physically. A lot of people who suffer from Burn-out Syndrome experience severe physical problems besides the psychological aspects of this disorder.
The stages of Burn-Out
As with any illness, symptoms of burnout change from person to person, however these five stages are commonly observed:
1: HONEY MOON PHASE:
High job satisfaction, energy, creativity and commitment to the job. The key issue is how you cope with the inevitable stress that comes with any job.
2: ONSET OF STRESS:
Stress kicks in, job dissatisfaction starts, concentration and efficiancy is decreasing but your head keeps busy at night what keeps you from sleeping. You might develop a general fatigue.
At work escapist activities are increasing (smoking, zoning out, etc..)
3: CHRONIC STRESS:
Chronic exhaustion; physical illness (remember that stress is a risk factor in many diseases); anger, depression
Physical symptoms intensify and/or increase in number; obsessing about work frustrations; pessimism and self-doubt dominate thinking; you develop an “escapist mentality”
5: HABITUAL BURN-OUT:
The symtoms of burnout are so embedded in your life that you are more likely to be labeled as having some significant physical or emotional problem than you are to be called a burnout case.
For more information about the stages and research regarding these: https://www.winona.edu/stress/bntstages.htm
Is it only the work that cause a Burn-Out?
Burnout often stems from your job. But anyone who feels overworked and undervalued is at risk for burnout, from the hardworking office worker who hasn’t had a vacation in years, to the frazzled stay-at-home mom tending to kids, housework, and an aging parent.
But burnout is not caused solely by stressful work or too many responsibilities. Other factors contribute to burnout, including your lifestyle and personality traits. In fact, what you do in your downtime and how you look at the world can play just as big of a role in causing overwhelming stress as work or home demands.
Treatment for Burn-out
The form of treatment depends on the stage of Burn-out the client is in.
One of our clients was admitted for outpatient treatment on request of his employer because of anger problems at work. What looked like a form of depression in the beginning, clearly showed to be the 3d stage of a Burn-Out development , because it was overly work-related. Because the burn-out wasn’t fully developed, it was advised that the client would keep on going to work, but he had to make major changes in his style of working. Even though he worked a lot- he didn’t seem to work efficiently and moreover, he himself assumed that he never did good enough because in spite of his efforts, he could never witness any concrete result of his personal work. And this wasn’t about money or salary benefits- he just felt this way because he never got the feedback he needed. So he seemed to have developed unrealistic expectations. Part of this was influenced by the way management reported to the employees. They only gave general feedback of the company’s gains and for quite some time now they talked about decreasing numbers.
Fortunately the boss of this client was very willing to support his employee, so one day they came together to the counselling session. Backed-up by the psychologist, the client finally asked his boss about realistic feedback and could tell him all the things that bothered him at work. It was a very constructive talk, in which not only the client learned important information but also his boss gained more insights about how his employees experienced working at the company.
Following this session, the boss of the company asked for consultancy from the psychologist about how to communicate better with his employees and implemented several burn-out-prevention- strategies suggested by the psychologist.
The client had 10 more sessions that were devoted to healthy self-care not only at work but also in regards to his private life in order to stay physically and mentally healthy in the future. Because in order to prevent a Burn-out at work, it is important to also have a healthy personal life.
Rehabilitation from a severe Burn-out
Some of our clients were not as lucky as the previous one and realized their problem when it already developed into a severe problem due to years of neglect.
A female Social Worker was admitted to outpatient treatment after months of medical tests and treatment didn’t present any concrete results and the doctors suggested a psycho-somatic problem. For more than 1.5 years she had chronic pain, severe migraines and significant gastric problems that caused her to lose 15 kg. She wasn’t able to work any longer and even needed help at home in order to cope with her daily tasks.
This made her feel extremely depressed as she was used to being the one that helps others and being useful was very important to her.
Due to the depression and physical exhaustion her cognitive abilities had even declined: she had severe problems to concentrate and her memory was very weak.
In this stage it would be too early to confront somebody with their personal features, that contributed to this state. She was even afraid of having a progressive neurological disease and her stress-level was chronically high.
So it was very important to first stabilize her and regain some basic physical energy. In order to achieve this, our life coach offered intensive support at home so she could regain basic physical stability. While the psychologist wrote a treatment regime for this client in the form of a week/ day program, the lifecoach supported her in exercising the daily tasks and reminding her of not setting her goals too high but to focus on these basic physical needs of healthy food, a healthy day structure and regular sleep besides physical exercise.
As simple as it sounds, for a highly driven and mind-strong woman, this was extremely difficult and she exposed the tendency of falling back into passive worrying.
But the lifecoach always stimulated her to stay active and concentrate on the basic daily tasks. After one month her physical condition got slowly on better but she kept on worrying and being tense and anxious. That is when the psychologist and lifecoach implemented mindfulness-exercises to help her calm her mind.
Due to the newly developed discipline that was enforced by the lifecoach, her cognitive abilities improved. She could concentrate better, ruminate less and her memory improved.
That was when the Psychologist could start the counselling sessions. At the beginning the client showed a lot of self-doubt, disappointment and anger towards herself. Slowly this turned into grief and later on into a series of self-discovering events when she started to understand which personality traits lead her into overworking herself and how they were connected to her past.
By understanding which self-owned expectations lead her to the burn-out, she slowly let go of unrealistic ideas and expectations that she had towards herself and started to understand what she actually really needs and wants. She started creating a more realistic self-image and began to take better care of her real needs. While she first focussed on her social and leisure activities only later on she started re-orientating on her personal and occupational interests. And she decided to take a course in creative therapy, which actually fit better to her wish to contribute to clients in a positive way.
After 9 months she started an internship as a Creative Therapist and 3 years later she is still working at that facility.
She has a very different life now. She still cares for others and wants to help them, but now she can take care of herself first and is more satisfied with her personal and occupational life than ever before.
Prevention of Burn-out
All the above cases could probably have been avoided with the right care at the right time.
But how can you do that?
At the workplace prevention of Burn-out can be implemented on 3 different levels:
The individual, the team and the manager and the organization.
On an individual level you can ask yourself the following questions:
Do I like my job and do I want to pursue this career? Is my workload realistic and are my tasks well organized? Do I ask for help, feedback and support if needed? Do I put down clear boundaries and do I handle a good balance between work and private life? Do I have a healthy and relaxing private life? Can I manage stress in general and do I relax enough?
If not, this could be an important starting point to start developing your skills. Depending on the topic and your own resources you can talk about this with your manager or a jobcoach.
On a team and management level it is important to make sure that you are working within a functional team with a clear structure, clear goals and job expectations. Is the workload realistic? Are procedures, responsibilities and tasks clear to everyone?
Having regular talks (besides team meetings and performance evaluations) helps a manager to stay in tune with all team members and to make sure that the mutual expectations and needs are clearly expressed. Make sure that these talks can be honest and open without any repercussions.
The manager has a key role in creating a healthy and positive work environment. Besides motivating performance and efficiency it is also important to stimulate positive self-care like taking breaks, eating healthy and going home on time.
As an organization there is a lot you can do to prevent burn-out among your employees. Every company wants to have happy and healthy workers because that benefits the productivity and the allover success of the business.
Many aspects contribute to a healthy work environment.
It starts with a compatible physical work environment, where lighting, seating, noise control etc fit the standards of stress-free working.
Obviously it is also important that the organizational structure, roles, tasks and goal-setting meets the expectations and needs of an efficient work-flow.
Roles and tasks have to be useful, helpful and realistic as well as team meetings and gatherings which need to be useful and well-balanced in order to serve their goals.
But most important are the communication style and the work-culture, that your company tries to promote.
Don’t only stimulate work- performance and goal-archievement but promote a healthy work- leisure balance as well.
Employees with a stable and healthy personal life are in the end more productive than the ones who burn themselves out for the company.
Encourage relax-time by emphasizing the importance of breaks, after-work life, weekends and holidays.
Expand wellness programs and benefits. Stimulate physical health and mental health programs, make mental health a topic people dare to talk about and take it serious.
Be cooperative in flexible work-options and family-friendly work solutions so employees don’t have to juggle constantly with the different and often clashing demands of work and home life.
High – stress functions could be supported with stress-management and coping trainings.
Regular fitness and cycling to work are options that should be encouraged.
Last but not least create a culture of recognition. This can be done with the little things like saying “ Thank you” or mentioning individual efforts during meetings. People who feel recognized tend to invest more at work. Positive recognition leads to a higher motivation, better performance and less turnover.
Only a healthy organization can create sustainable success