Burnout in the Helping Professions
“There’s no shame in taking a step back to focus on self-care.” As I was saying this to one of my clients recently, it hit me: if I truly believe that, then I need to practice what I preach! It was obvious to me that my client was suffering from burnout, due to the demands of her job as a mental health professional as well as her family caregiver responsibilities, and equally obvious that she absolutely deserved to set some boundaries, ask for help, and take a break to recharge her batteries. And yet, even though I was beginning to see signs of burnout in myself, it was a real struggle to acknowledge this, and give myself the same permission to step back.
This is the dilemma that many of us in the helping professions face: if you’re a nurse, doctor, psychotherapist, social worker, or teacher, you may have received training to recognize the signs of burnout, and you may know what to tell your patients, clients, or colleagues to do to relieve it. In fact, you might spend your days counseling others to take a step back, set some boundaries, reach out for help, and get some rest. But when it comes to you, you’re far more likely to tell yourself to just push through the exhaustion, and ignore the growing cynicism and feeling of detachment from the work that you used to love.
So what exactly is burnout? The World Health Organization (WHO) defines burnout as “a syndrome resulting from chronic work-related stress, with symptoms characterized by 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.”[1] It is not a medical condition or mental disorder.
Christina Maslach, professor emerita of psychology at UC Berkeley and co-author of the Maslach Burnout Inventory (MBI), describes burnout as “feelings of exhaustion, inefficiency and cynicism, defined by a detachment from work and a lost sense of meaning.”[2] Developed in 1981, the MBI was the first instrument to measure burnout, and remains widely used today.
Are people in the helping professions more likely to experience burnout? According to recent surveys [3,4], burnout seems to be growing among workers across occupations, fueled by COVID-19 pandemic-related trends in working from home, remote schooling for children, and staffing shortages. But healthcare workers and educators have been hit the hardest, and even prior to the pandemic, these occupations have historically been most impacted by burnout. To understand why, we can examine the traits of people who are most vulnerable to burnout, but even more importantly, we need to look at the characteristics of jobs that burn people out.
Burnout doesn’t happen to slackers, but rather to those who are the most conscientious and hardest working, and who regard their work as a calling.[5] The traits of people who are most vulnerable to burnout include:
- Being a helper, by nature or occupation;
- Scoring high on conscientiousness and agreeableness (Big Five Personality test);
- Taking pride in one’s work ethic and dedication;
- When the going gets tough, they don’t quit, they just work harder; and
- They believe that asking for help is a sign of weakness.
Do any of those ring true for you?
Burnout is caused by chronic and excessive job-related stress, not by any deficiency in the individual. The characteristics of occupations that have highest rates of burnout include:
- Involving the provision of direct services to people in the areas of health, mental health, and primary education;
- Responsibilities are loosely or vaguely defined, additional responsibilities are constantly being added;
- Success is difficult to measure, there’s never an endpoint or goal post;
- Rewards are intangible, few, or fleeting;
- Job demands exceed what is humanly possible, given time and resource constraints.
Therefore, it is increasingly difficult to do the job well, or meet the needs of those you are supposed to serve. Does this sound like your job?
How do you know if you’re suffering from burnout? In my experience, these are the key signs:
- You’re more impatient or irritable than usual;
- You don’t feel well-rested after a night’s sleep;
- You’ve stopped doing activities that normally bring you pleasure or involve self-care;
- You find yourself saying or thinking more often, “I just don’t care” about your job; and
- You don’t feel ready to go back to work after your regular days off.
You may also find yourself getting more and more behind on routine work and household tasks, and thinking more often about quitting, changing jobs, or retirement.
A key point: burnout is not the same as depression. Because there is a significant overlap of symptoms, those who are suffering from burnout may believe, or may be told, that they’re clinically depressed, however, the causes of burnout are different, and so is the treatment. (Of course, it’s possible to have both burnout and clinical depression, in which case you will need to address both conditions.)
What is the treatment for burnout? Ideally, a signficant amount of time off work. For some people, a couple of weeks might be enough, for others, a month to a year may be needed. Of course, this is not possible or realistic for many people, so then you will need to implement these self-care tasks while continuing to work:
- Start with setting some boundaries. Learn to say “no,” or “not now,” and let go of any non-essential tasks;
- Ask for help from colleagues, or delegate if you can;
- Prioritize getting more sleep and exercise, eating healthier, and reaching out to family and friends for social connection;
- Change your attitude or approach to work. Become willing to be “good enough” rather than “great;” commit to leaving work on time, or if you work from home, create boundaries to separate work from home and family life;
- Take some time to review your life goals, and what gives you a sense of meaning and purpose. If it’s not your job anymore, then begin to explore other options.
- Finally, I highly recommend seeking out a psychotherapist to assist you in this process.
When I saw my client again, she seemed a bit happier, and reported that she had set some limits with the family members who had been most demanding of her time. She’d also resumed her exercise routine, was making plans for a trip with friends, and was actively looking for a job that was less direct-service oriented. And how did I address my own incipient burnout? I have decided to take a break from teaching mindfulness classes, even though I love doing so, to give myself more time for rest, relaxation, exercise, and visits with friends and family.
Notes:
1. Burnout an “occupational phenomenon”: International Classification of Diseases WHO. 28 May 2019. Referenced in Wikipedia page on occupational burnout.
2. Christina Maslach, quoted in Zuckerman, C (2021, April 30) How to Beat Burnout without Quitting Your Job. NYT online, retrieved March 28 2022.
3. Survey by Robert Half Int’l, referenced in Maurer, J. (2020, December 16) Remote Employees Are Working Longer Than Before. Retrieved from SHRM HR Today, online ed.
4. Threlkeld, K. (2021, March 11) Employee Burnout Report: Covid-19’s Impact and 3 Strategies to Curb It. Retrieved from Indeed.com.
5. From “The Exhaustion Funnel,” handout from my MBCT course.