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In today’s fast-paced world driven by technology, immediate gratification and materialism, many endeavour to sustain a work rate that eventually results in physical, mental and emotional exhaustion. It is known as ‘Burnout’. What are its causes and effects, and how can we overcome it?

WHAT IS BURNOUT?

The term ‘burnout’ was first introduced in 1974 by psychologist Herbert J. Freudenberger, who observed behavioural, emotional and cognitive debilitations among overcommitted community workers. He described it as a negative work-related psychological state with symptoms of physical fatigue, emotional exhaustion and de-motivation. In 1976, Christina Maslach, an American social psychologist and professor emerita of psychology at the University of Berkeley, California, defined ‘burnout’ as ‘Consisting of mental/emotional exhaustion, negative perceptions and feelings about clients or patients (depersonalization/cynicism), and a crisis in professional competence (reduced personal accomplishment)’.
Burnout is a consequence of prolonged work-related stress characterized by:
  1. Emotional exhaustion; most widely reported in research literature and the most significant component.
  2. Cynicism towards the value of one’s work leading to detachment and withdrawal from the job.
  3. Negativity towards oneself due to work inefficiency or lack of accomplishment and efficacy.
Symptoms of burnout are job-related and situation-specific, whereas, notably, depressive symptoms are typically generalized to all other situations and spheres of life. Burnout generally results from stress that comes about through the social relationship between a helper and a help recipient, usually found in asymmetrical professional relationships, whereby the victim is the ‘giver’. Burnout has also been referred to as ‘compassion fatigue’, and this definition may be more appropriate for care providers.

PREVALENCE

Burnout can manifest in any person in any profession and the number of individuals suffering burnout is continuously on the rise given the demands of the modern work environment. The estimated prevalence of severe burnout varies between 2% and 7% in working populations. Most studies on burnout have focused on the health profession, though there is a growing prevalence of burnout in the general working environment as technology results in 24 hours-a-day availability and access.
An estimated 22% of physicians in the USA, 27% of physicians in Great Britain and 20% of physicians in Germany suffer burnout. Similarly, about 30% of teachers are affected and some studies report up to 40%.
Another survey suggests that 46% of US physicians report at least one sign of burnout.
The growing demands from a workspace driven by financial targets pushes us beyond our ability to cope. As much as we may have progressed technologically we don’t have the understanding that spirituality provides to cope.
On 30 April 2006, Dr Prashant Chhaya, an orthopaedic surgeon, asked Pramukh Swami Maharaj in Junagadh, “I cannot properly manage five staff members in my clinic, yet how do you manage such a large organization?”
“God is the all-doer,” Swamishri replied succinctly.
“That is true, but you are the instrument. How do you manage everything?” Prashantbhai persisted.
“By believing God to be the all-doer everyone is inspired to make an effort. Because God resides in everyone, he is the inspirer. One should do one’s work by understanding the glory of everyone, by pleasing God and understanding him to be the all-doer. One should also pray to God for one’s intentions to be pure and to give everyone the strength to work.”
Pramukh Swami Maharaj’s profound answer to the question reflects his absolute faith in God and his message to work with the purest of intentions.

CAUSES OF BURNOUT

Work Environment and Burnout
The work environment leads to the development of burnout due to mismatches between individuals and their job assignment in terms of:
  1. Workload
    It usually results from an excessive quantity of work, although it can also be due to a mismatch between the job requirements and the skill set of the worker.
  2. Lack of Control (or Autonomy)
    Refers to not having the necessary resources and authority to complete any assigned task in an efficient manner.
  3. Effort-Reward Imbalance
    Usually refers to financial compensation; also, recognition for a job well done or a personal sense of accomplishment.
  4. Community, Camaraderie and Affinity
    Refers to the sense of connection with others in the workplace. Unresolved personal conflicts within the work environment can be particularly destructive.
  5. Fairness
    A perceived lack of fairness is emotionally upsetting and can lead to cynicism.
  6. Values
    The individual and the institution’s values must be consistent. An individual’s job expectations and assigned task must be consistent with his or her own personal value system. Furthermore, the institutional practice must be consistent with its overall mission.

CHARACTER AND BURNOUT

Higher rates of burnout result from certain individual and personality traits, including perfectionism, indecisiveness, self-criticism, inflexibility, idealism, type A personality and empathy. Younger individuals seem to be more prone to burnout, although age may be a confounder for work experience. Individuals who are single seem more prone to burnout. Individuals who are meek, have low self-esteem, and who attribute outcomes to events outside of their control are prone to burnout. Also, individuals with high job expectations are more prone to burnout because their expectations often lead to working harder. Thus burnout facilitates interesting paradoxes.
Paradox 1: The current behaviours that we identify, encourage, and reward are the most likely to result in burnout.
Paradox 2: The personality traits that suggest a lifetime of success lead to burnout.

INDIVIDUAL CYCLE LEADING TO BURNOUT

  1. Compulsion to prove oneself
  2. Working harder.
  3. Neglecting personal needs.
  4. Displacement of conflict.
  5. Revision of values.
  6. Deny emerging problems.
  7. Withdrawal.
  8. Obvious behavioural changes.
  9. Depersonalization.
  10. Inner emptiness.
  11. Depression.
  12. Burnout.
This is not necessarily a linear process, and individuals may demonstrate features consistent with many steps simultaneously. There is an initial compulsion to prove oneself that leads individuals to work harder, endeavouring to demonstrate intellectual capability, thus neglecting personal and family needs. During this process, individuals begin to realize that something isn’t quite right in terms of their personal/professional life, but can’t recognize the conflict. As they continue to focus on career, they revise their value system such that work is of paramount importance to the exclusion of other outside activities and the source of their self-esteem. They become intolerant and cynical towards their colleagues who don’t share their work commitment and can become socially withdrawn. This leads to further behavioural changes and an internal sense of worthlessness. As the process deteriorates, individuals fail to see themselves or others as valuable, leading to a further sense of emptiness that can lead to exaggerated maladaptive behaviours, e.g. substance abuse. This ultimately leads to depression and burnout.
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