Burnout Syndrome

2024 Author: Harry Day | [email protected]. Last modified: 2023-12-17 15:43

What's this?

Emotional burnout is a state of physical, emotional and mental exhaustion that manifests itself in the professions of the social sphere: rescuers, doctors, teachers, counselors, etc. The onset of exhaustion in the event of burnout is associated precisely with the human-to-human interaction.

The term "burnout" was coined in 1974 by the American psychiatrist H. J. Freidenberg to characterize the state of healthy people who are in intense emotional communication with clients in the provision of professional care. Burnout is exacerbated (but not defined) by any other negative circumstances: insufficient pay, lack of recognition from others, poor working conditions, overwork, etc.

Clinically, burnout is a pre-illness condition, and refers to stress associated with the difficulty of maintaining a normal lifestyle (Z73) according to ICD-10.

What does it look like?

Burnout syndrome (according to V. V. Boyko) can be conditionally divided into three phases:

Phase I - tension of psychological defenses of the personality

Everything seems to be fine, but emotions are muffled, the acuteness of feelings and experiences disappears. Everything becomes boring, my soul is empty, my favorite work does not make me happy, dissatisfaction with myself and even a feeling of my own uselessness, lack of a way out.

Suddenly, supposedly for no reason, the internal conflicts of the personality, which were previously dormant inside, are activated, and a state of depression creeps up.

Phase II - resistance, resistance of psychological defenses

People with whom a person works begin to annoy him, especially clients and visitors. The person begins to dismiss them, and then almost hate them. At the same time, a "burnout" person himself cannot understand the reason for the growing wave of irritation in him.

In the phase of resistance, the possibilities for working in the proposed mode are exhausted, and the human psyche begins to unconsciously change the regime, removing the factors that have become stressful: sympathy, empathy, empathy for people - and, preferably, the people themselves too: the further people go, the calmer.

Phase III - exhaustion

At this stage, there is a loss of professional values and health. Out of habit, the specialist still retains his respectability, but the "empty gaze" and "icy heart" are already visible. The very presence of another person nearby causes a feeling of discomfort and nausea, up to real vomiting.

In this phase, the resources of the psyche are completely exhausted, somatization occurs. There is a high probability of heart attacks, strokes, etc.

How does this happen?

There is no single point of view on how burnout occurs. From the point of view of logic, the key in this process should be the contact "person-person". What are the differences between him and other types of contact - with cars, documents, and other soulless objects? The only significant difference is the possibility of emotional empathy for the interlocutor, the possibility of empathy, and, accordingly, the possibility of psychological retraumatization.

… It should be mentioned here that, of course, with any personality deformations, burnout occurs faster. So, for example, the inability to plan your time in any profession leads to overwork. Perfectionism is the desire to “save everyone from everything”, which by definition is impossible, which means that it leads to a drop in self-esteem. Etc. But all these problems are typical not only for the professions "man-to-man", and everywhere lead to very sad results, so that they cannot be considered key for burnout. Burnout is exacerbated by any unfavorable circumstance, but what is causing it?

The main thing that distinguishes helping professions from all others is constant contact with people, often with people in difficult or unfavorable circumstances, with people who need help, participation and empathy. What happens with empathy? - the term co-experience itself presupposes the experience of feelings similar to the feelings of the interlocutor.

Somatic resonance

In the body-oriented psychotherapy groups, which I periodically conduct, there is such an exercise: the participants are divided into pairs, and when the first, closing his eyes, makes movements that convey his mood - as if dancing the appropriate dance - the second repeats the movements after him. Often after a while, the second participant begins to understand the first so well that sometimes he even foresees the movements that the counterpart will make in a second, despite the fact that people do not communicate verbally at that moment, and the “dance” does not have any structure. During the sharing, when the participants describe their own experiences, it usually turns out that the experiences of those who were in a pair coincided - if the first danced sadness, then the second was also sad, if the first danced joy, then the second also felt fun.

This phenomenon in the bodily paradigm is called "somatic resonance", in NLP - attachment, and, in general, it can occur not only consciously, but also completely unconsciously. Each of you can conduct an experiment by asking someone to look closely at the screen during the time. If the viewer is really keen on watching, you, watching him carefully, can see how in sad places where the actor gives out a grimace of incredible tragedy, the corners of the viewer's mouth also slightly lower, and in places where the actor demonstrates relief, the viewer's face is slightly smoothed … And this happens without any conscious intention.

The same thing happens with any attentively listening person when he is captured by the emotions of the narrator: he begins, as it were, to share the emotions that are seething in the story, and to live them with a partner. That is, it unconsciously enters into a bodily resonance. Such attachment helps not only to understand the other person, but also to give him acceptance and security: on a non-verbal level, the resonance of the interlocutor, as it were, tells the narrator that he is understood and there is no evil against him. Without this ability to empathy, perhaps, professions of the "person-to-person" type are generally contraindicated.

Unfortunately, if the person who joined has stored in the unconscious some of his own emotional charge on the same topic, this charge is activated and, as it were, “added” to the emotions received from resonance. It is the presence of an unconscious emotional component that is important here: it is it that is a marker of internal conflict. The presence of an emotional charge in the unconscious indicates that awareness in such situations does not occur to the end, there is an internal conflict.

To demonstrate this mechanism in the already mentioned groups, one more pair exercise is proposed - when a participant with closed eyes receives the task to simply "gather his face" to a point, a purely physical exercise, while the partner closely monitors not only his facial expression, but also for their own feelings. Often a person, even knowing for sure that the partner is just doing the task, not including emotions, notices that he is beginning to project his own feelings onto him.

Thus, empathy sometimes stirs up the helper's own unprocessed traumas - secondary trauma comes along and leads to depression. An unconscious inner conflict repressed by psychological defenses wakes up, an unconscious emotional charge is actualized, and more and more power of psychological defenses is required in order to protect oneself from emotional pain. Over time, there is a breakdown, anhedonia, and other delights of an impending depression …

But it was only that half an hour he listened to a man talking about his grief a couple of weeks ago. The story then somehow resonated deeply inside, but then the turnover, business, everything seemed to drag on … and often a person does not at all connect the current state with the reason that caused it. For the unconscious conflict is not recognized.

What to do?

Pass through which you can test yourself. If you have fully formed the first phase, it's time to start rehabilitation activities - look for Balint groups, go to a psychotherapist, or at least take a vacation and engage in self-recovery and self-exploration. I will not even talk about the second and third phases, you yourself will guess.

If there is no emotional burnout yet, for the future it is worth observing some safety rules when dealing with people who need your help and sympathy. This will allow you not only to maintain your own health, but to more effectively carry out professional duties - that is, in the end, help more people.

1. Half of the attention is on yourself

• Be sure to arrange "breaks" - a time when you can consciously listen to yourself and only yourself. If possible, this time should be spent on removing the remnants of body resonance (item 3).

• Listen to yourself and directly during communication - you need to learn to track your emotions, if possible, separating those that are empathy and directly arose from resonance, from your own.

• Feel your breath. Holding your breath is a sure sign that you are entering a dangerous emotional area for yourself. It's time to loosen contact with your partner or even transfer it to another specialist.

• Track your own body sensations. If any sensations from item 2 began - there is a great danger of secondary trauma, it's time to urgently disconnect.

2. Signs of secondary trauma

• Increased heart rate

• Uncontrolled tremors

• Unmotivated irritation

• Uncontrollable or inappropriate tears, crying

• Inability to act, stupor, confusion

• Unexpected inner restlessness, increased anxiety

• Exhaustion, instant loss of interest in what is happening

• Temporary instant depersonalization and derealization

The criterion here is the breadth of perception and the ability to fully respond to what is received from the resonance. Tears, trembling and confusion received from a partner, being conscious, intensified and expressed, do not have a negative effect. At the same time, a "simple" heartbeat, during which a narrowing of perception occurs - the impression that it is impossible to get out of this sensation, that you do not control it - indicates a secondary traumatization.

3. Removal of body resonance

• Disidentification: Remind yourself that you are you. It is useful to say to yourself something like: "I am Olga Podolskaya, I am a psychologist," and to say not to myself, but loudly, so that you can hear your own voice.

• Disconnection: Change your posture, breathing rhythm, walk, look away, look out the window, etc.

• Change in tactile sensations: Give your body a new sensation: wash your hands, rinse your face, drink tea or sip water, go to the toilet, get some fresh air or sniff coffee beans. If necessary, take a shower and completely change all your clothes.

• Unusual Activities: Do a couple of physical exercises, and the weirder they are, the better: you need new emotions. Do a few dance steps, jump from a chair, whatever, from what you have never done and that will not leave you indifferent.

• Relaxation: Learn to relax, distracting yourself from any thoughts at all, focusing on the sensations of your own body, and give yourself this pleasure every time you come home from work.

If all of the above did not help you, and retraumatization did occur - it depends not only on the maturity of your defenses, but also on the strength of the traumatic factor: in some situations, secondary injury is almost inevitable (in particular, when rescuers work in disaster areas) - plan rehabilitation measures: personal therapy associated with working out the injured trauma, reducing the workload, restoring the general resources of the body.

I hope what I have written will help you to work long and efficiently!