Burnout is a psychological term that refers to long-term exhaustion and diminished interest in work. 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 and specified as a "State of vital exhaustion" (Z73.0) under "Problems related to life-management difficulty" (Z73), but not considered a "disorder".
The most studied measurement of burnout in the professional literature is the Maslach Burnout Inventory. Psychologists Christina Maslach and Susan 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 condition. 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 views 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 measures of job function (performance, output, etc.), health related outcomes (increases in stress hormones, coronary heart disease, circulatory issues) and mental health problems such as depression. In the only study that directly compared depressive symptoms in burned out workers and clinically depressed patients, no diagnostically significant differences were observed between the two groups; overall, burned out workers reported as many depressive symptoms as clinically depressed patients. It has been found that patients with chronic burnout have specific cognitive impairments, which should be emphasized in the evaluation of symptoms and treatment regimes. Significant reductions in nonverbal memory and auditory and visual attention were found for the patient group. 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.
Tracy's study of workers aboard cruise ships describes burnout 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 problem caused by long hours, little down time, and continual peer, customer, and superior surveillance".
How pressure is dealt with determines how much stress someone feels and how close they are to burnout. One individual can experience few stressors, but be unable to handle the pressure well and thus experience burnout. Another person, however, can experience a far greater number of stressors, but effectively deal with them, and avoid burnout. How close someone is to a state of burnout can be determined through various tests.
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 one's desire to prove themselves while at the workplace. This desire turns into determination and compulsion.
Working Harder Because they have to prove themselves to others or try to fit in an organization that does not suit them, 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. It may happen that 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 and energy for anything else. Friends and family, eating, and sleeping start to become seen as unnecessary or unimportant, as they reduce the time and energy that can be spent on work.
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. 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 while their perceptions change. They also change their value systems. The work consumes all energy they have left, leaving no energy and time for friends and hobbies. Their new value system is their job and they start to be emotionally blunt.
Denial of Emerging Problems The person begins to become intolerant. They do not like being social, and if they were to have social contact, it would be merely unbearable for them. Outsiders tend to see more aggression and sarcasm. It is not uncommon for them to blame their increasing problems on time pressure and all the work that they have to do, instead of on the ways that they have changed, themselves.
Withdrawal Their social contact is now at 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". They often have feelings of being without hope or 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.
Depersonalization Losing contact with themselves, it's possible that they no longer see themselves or others as valuable. As well, the person loses track of their 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 feel empty inside and to overcome this, they might look for activity such as overeating, sex, alcohol, or drugs. These activities are often exaggerated.[clarification needed]
Depression Burnout may include depression. In that case, the person is exhausted, hopeless, indifferent, and believes that there is nothing for them in the future. To them, there is no meaning of life. Typical depression symptoms arise.
Burnout Syndrome They collapse physically and emotionally and should seek immediate medical attention. In extreme cases, usually only when depression is involved, suicidal ideation may occur, with it being viewed as an escape from their situation. Only a few people will actually commit suicide.
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 disconnection 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.
There are a variety of ways that both individuals and organizations can deal with burnout. In general, resting proves to be very effective. This may include a temporary reduction of working hours, slowly rebuilding the endurance of the individual. 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.
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.
Research has been conducted that links certain interventions, such as narrative writing or topic-specific training, to reductions in physiological and psychological stress.
On an individual basis, employees can cope with the problems related to burnout and stress by focusing on the causes of their stress. Various therapies, such as Neurofeedback therapy, claim to assist in cases of burnout. This type of coping has successfully been linked to reductions in individual stress.
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 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.
^See Kristensen, T.S., Borritz, M., Villadsen, E., & Christensen, K.B. The Copenhagen Burnout Inventory: A new tool for the assessment of burnout. Work & Stress, 2005, 19, 192-207.; Shirom, A. & Melamed, S. Does burnout affect physical health? A review of the evidence. In A. S. G. Antoniou & C. L. Cooper (Eds.), Research companion to organizational health psychology (pp. 599-622). Cheltenham, UK: Edward Elgar, 2005.
^ abcMaslach, C. & Leiter, M.P. The truth about burnout. New York. Jossey-Bass, 1997.
^Bianchi, R., Boffy, C., Hingray, C., Truchot, D., & Laurent, E. (2013). Comparative symptomatology of burnout and depression. Journal of Health Psychology, 18 (6), 782–787.
^ abcdefMaslach, C.; Schaufeli, W. B.; Leiter, M. P. (2001). "Job burnout". In S. T. Fiske, D. L. Schacter, & C. Zahn-Waxler. Annual Review of Psychology (52): 397–422.
^van Dierendonck, D.; Schaufeli, WB; Buunk, BP (1998). "The evaluation of an individual burnout intervention program: the role of inequity and social support". Journal of Applied Psychology (83): 392–407.
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