The Causes of Burnout
I’m sure we’ve all had those days when we just can’t motivate ourselves to give it our best at work. It is simply a normal part of life that our energy levels and motivation will wax and wane over time. But for some people the ‘waning’ never seems to stop, and work becomes an endless drag that keeps getting worse and worse.
This is ‘burnout’.
Occupational burnout remains a huge problem worldwide. According to a Gallup study in 2016 almost a quarter of workers in Germany (24%) feel tired and burned out. 22% confessed that they had mistreated their family and friends by snapping at them, or being otherwise rude, as a direct result of stress. And almost a third (31%) stated that they had experienced high levels of stress within the past day.
A report published in 2008 found that more than half (56%) of the doctors in the American Society of Clinical Oncology fulfilled the diagnostic criteria for burnout. Here in South Africa things are no better. Among our doctors and nurses burnout has been long recognized as a major threat. And while burnout may be more common in the caring professions the truth is that it can strike people in any field, and in any job.
It has been reported that half of South Africa’s workers do not take the annual leave that they are entitled to. Not taking the time to rebuild your energy reserves can make stress much more difficult to deal with. And occupational burnout is likely one of the main factors driving a plague of absenteeism that is costing the South African economy an estimated R14 billion annually. The sad truth is that very few of us are properly prepared to resist, treat, or recover from burnout at work.
But what is burnout? In technical terms burnout is a chronic form of exhaustion. A form of exhaustion that comes bundled with a negative state of mind relating to work, that consists of distress, a feeling of uselessness, an absence of motivation, as well as dysfunctional attitudes and behaviours towards work.
In practical terms this means feeling exhausted all the time. Being unable to do your job effectively. Thinking negatively about the work you do and the organisation you do it for. Engaging in unhelpful behaviours at work. And feeling tired and worn out in general.
Burnout is different to tiredness or stress because it is chronic. It can last for months or even years. It has been strongly linked to anxiety disorders, depression, emotional problems, and other health complaints that occur when someone experiences a constant state of stress. Burnout has been studied at length and what has been found is that it often follows a consistent set of stages, each more damaging than the last. But more on that later.
To understand what causes burnout we’ll need to drive into research by Steven E. Hobfoll. Before Hobfoll ‘stress’ was thought to either be a physical reaction to a dangerous event or an emotional reaction to a perceived threat. The first approach pointed out that reactions to stress involve increased heart rate, sweating, shortness of breath and a medley of other symptoms that were clearly completely physical. Therefore, they argued, stress must be a physical phenomenon.
But the second group pointed out that something can be entirely harmless and still provoke extreme levels of stress in a person. Someone who has a severe phobia for cats can be driven to a state of complete panic by a mere painting of a cat. Their stress levels can be ruinously real, even though no actual danger exists. Therefore, this group argued, stress must be primarily in the mind. If you think something is stressful, then it is.
In essence, the one school of thought argued that stress was entirely physical and the other argued that it was entirely mental. Many researchers attempted to unite these two schools of thought with limited success.
Stress as a Loss of Resources
What Hobfoll did was create a model of stress and burnout that is broad enough to encompass both physical and mental stressors. He called it the ‘Conservation of Resources’ (CoR) model. Hobfoll persuasively argued that stress is all about the loss of “resources”. In his model a “resource” can be anything that we consider to be valuable. Anything that the person values is a resource to them. Money, love, status, material possessions, intelligence, family, physical health: anything that a person considers valuable constitutes one of their resources.
Hobfoll stated, and I doubt any of us would disagree, that all people strive to protect the things they value, and to get more of those same things. This is hardly a radical statement: people try and get the things they want, and hold onto them.
But the model goes further and posits that all stress can be traced back to these resources and that, if you think about it, there are actually only 3 kinds of stressful events:
Stressor 1: The actual or potential loss of a resource.
For example, losing a loved one is devastating, for any number of reasons. Those we love are a great resource for protecting our wellbeing, and we (hopefully) offer the same to them.
But even the possibility of losing a loved one is stressful. If one’s child takes ill their poor health can be terrifying, even if they later recover. The anxiety was real, even if the danger was not. In a workplace context retrenchments can be extremely stressful, even for the people whose jobs are secure, because the fear of being kicked to the curb flairs up and because friendships and relationships are often lost.
Stressor 2: When we ‘invest’ resources in something and don’t get the reward we feel we deserve.
This type of stress needs some explanation because it can be one of the major drivers of burnout, and it is all about being rewarded for your hard work. Investment bankers have an extremely stressful job, possibly one of the most stressful in the world. But they are typically paid very well for their efforts and so the job remains attractive.
Nursing is arguably an even more stressful occupation, but nurses are typically paid rather poorly, and often work in highly challenging conditions. Imagine trying to calm someone who is dying, and knows it. Now imagine doing that several times a week, on top of a hundred other duties, for insufficient pay. It is little wonder that South Africa’s nurses are burning out at an alarming rate.
However, this type of stress does not need to be as dramatic as that. In fact it doesn’t even need to be about money. If someone ‘invests’ a large amount of time and effort into a project, only to see someone else steal the credit, this can be highly stressful for them. People who are quiet and introverted are often overlooked for promotion because they don’t talk about their accomplishments or how hard they are working.
Not being recognised for the effort you’ve put in means you have spent resources but not gotten the affirmation, or other reward, that would build your resources up again. In each of those cases a person has invested the resources of time, effort, emotional energy and so on, because they were expecting to be rewarded. When the reward doesn’t arrive it causes stress.
This brings us to a top tip for any managers who are reading this: give affirmation and recognition to the people in your teams. Don’t go overboard, don’t make a big production out of it. Just show them that you’ve noticed their effort, and that the effort is appreciated.
Stressor 3: Having insufficient resources to meet demands
The last type of stress is one that almost all of us will be familiar with: not being able to keep up with the demands that are placed on us. It can occur because we’re overloaded with tasks and simply don’t have enough time for all of them. Unexpected expenses can deplete our financial resources so that we can’t pay our bills. Injuries and illness can make it impossible to do activities we enjoy, and so on.
But, what makes burnout occur in these cases is the fact that an extended period of stress caused by insufficient resources tends to damage our other resources as well. We don’t have enough time to do our work assignments so we stay late at the office. This means we are forced to cancel dinner plans which harms our relationship with our spouse and our friends. Because we lose this support network we start keeping our feelings inside which erodes our resilience and our reserves of emotional energy. In extreme cases working individuals may even lose their jobs because their performance has fallen too far.
This insidious progression from problem to crisis to catastrophe is one the key markers of burnout syndrome. In fact, as I mentioned above, burnout often follows a predictable pattern. And knowing what this pattern is and how it manifests itself can help us to identify burnout in ourselves and others.
Signs of Burnout
The first sign that something might be wrong is exhaustion. This is not the tiredness that comes from working hard and achieving our goals. It is a constant state of low energy. Everything you do requires you to force yourself. Everything becomes difficult, you’re always tired, and you never seem to be able to get enough sleep to make up for it. This is the most common sign of burnout.
Unfortunately, the second sign of burnout is much more difficult to spot, because it entails the burnout steadily eroding the person’s belief in the work they do, and the organisation they work for. One of the most widely used tests of burnout is the Maslach Burnout Inventory created by Christina Maslach and Susan E. Jackson. One of its key measures (after exhaustion) is ‘cynicism’. So the negative effect that burnout has on one’s attitude is very real, and the reasons why are interesting.
A person who is in the process of burning out is not going to be able to meet their work obligations. This will make their stress levels get worse in several ways. One of those ways is that the person will feel bad for their failure. Most people take pride in being able to work effectively. When they no longer can they feel ineffective, even useless, and this is a completely different type of stress.
Typically, what happens next is that the person appears to stop caring about their work performance. In a strange way this is actually a defence mechanism. Remember, they are ‘stressing out’ in part because they put value in their work performance; they care about doing well. So the way of reducing that stress is to stop caring.
Naturally, this doesn’t solve the underlying problem which is not having the resources to meet the demands that are placed on them. And in the long run not caring about whether you’re performing at work is only going to create more stress as your co-workers start to notice that you aren’t carrying your weight.
Stopping the Downward Spiral
This is another example of the trend of burnout steadily and surreptitiously wearing away at our defences. When we are struggling under unbearable stress we often use coping mechanisms that work in the short term but make things worse in the long term. We’re far too busy so we don’t go to gym. As a result our fitness suffers and this lowers our energy levels, making everything even more difficult. We don’t feel like cooking a healthy meal so we get fast food instead. Over time this causes obesity that tires us out and causes back pain. And there is the above-mentioned example of people who spend too much time at work, and thus alienate their family and friends.
Lower performance inevitably leads to more stress and fewer resources. Perhaps we get fired, perhaps our husband divorces us because we are no longer the ‘breadwinner’, or perhaps problems at work will simply continue to escalate until a catastrophe occurs. The point is that burnout is a downward spiral. Unless you take steps to combat it.
The good news is that there are a number of things that have been shown to improve people’s ability to battle burnout. The first and most obvious is lowering someone’s workload. If a person in your team seems to be struggling take some of the pressure off for a while and give them a chance to recover. And remember: the stress doesn’t have to come from work to have an impact on work. If someone suffers a tragedy their emotional resources will be depleted, and they might not have enough left to work effectively.
A very important change that might not occur to one is removing “role confusion”. This occurs when people aren’t quite sure what their responsibilities are, or which person is responsible for a certain task. This raises stress levels because it means employees aren’t sure whether they are doing the right thing. It also means that managers are likely to explode with annoyance because a certain task hasn’t been done, or has been done incorrectly.
I used to work in an organisation where the head of our department never gave us deadlines for any of our tasks. We were only told that something was due when the due date had arrived. It was, without a doubt, one of the most stressful environments I have ever worked in.Lastly, offering emotional support (whether internally or externally) to employees who seem to be swamped is one of the most helpful and most obvious ways of battling occupational burnout.
But remember that at its core burnout is all about managing resources, and ensuring that we have enough to face the challenges we are confronted with.