Burnout The New Global Pandemic

John was in a bad place when he came to see me for a scheduled appointment at the surgery; broken and burnt out from years in a toxic work environment, where enough was simply never enough.

In his own words, 'I feel exhausted, a failure and really frustrated.' He had lost his spark, he had difficulty feeling joy. His emotional bank account was empty.

These symptoms had crept up slowly over some time and it was his teary eyed wife who had arranged the initial appointment. We spoke about sleepless nights and his sense of burnout. Johns solution of working harder and harder simply wasn't working any longer. 

John needed treatment to escape those dark hours, time out from the workplace and a number of sessions of cognitive behavioural therapy with a trained therapist.

He also spent a number of sessions with me rediscovering his purpose and building a renewed sense of vitality, learning how to craft his job as more of a calling. 

I'm glad to say that today John is back to his best. Enjoying his work much more, engaged again with his hobbies, spending quality time with his family. Rather than simply becoming a victim of burnout, he sought help, made some changes and came back stronger than ever. 

John learned that he had the power to choose resilience and responsibility over victimhood and to write his own prescription for inner contentment and real healing.

So what exactly is burnout? 

First described as far back as 1974, burnout syndrome has become a global pandemic in the 'never off' digital corporate workplace. A symptom of modern life where more people than ever are struggling and searching. 

While people from any profession can develop burnout, it is particularly prevalent among the caring professions. It's a known fact that up to half of all medical doctors - the healers themselves - are also affected with some degree of burnout. This is borne out by recent scientific research from Journal of the American Medical Association that the prevalence of burnout among practicing physicians in the United States exceeds 50%.

Caring is wearing as any doctor will tell you. No one is immune.

Burnout is characterised by a combination of the following symptoms: 

- Depersonalisation (and sense of cynicism).

- Exhaustion, not just physically but also a profound sense of emotional exhaustion.

- Reduced effectiveness at work and a lack of personal accomplishment. 

These symptoms tend to creep up gradually; in fact the person experiencing burnout may be the last to realise what's already self-evident to those around him/her (just like John).

I think of burnout as like a philosophers stone gone awry. Legend had it that the mythical philosophers stone could turn base metals into silver and sparkling gold. Burnout is the reverse: whereby the passionate energy and purposeful engagement of the brightest and best talent becomes transformed into a dimmer, disillusioned and chronically exhausted version of themselves. 

Multitasking - Digital Overload

More and more people are chronically distracted with competing priorities for their attention and focus. This is one of the real unfolding downsides of digital devices, all that distraction burning valuable brain energy. 

A Microsoft study found that it takes people an average of 15 minutes to return to an important project after an email interruption. Multitasking is exhausting and highly ineffective; switching to a new task while in the middle of another increases the time taken to complete both tasks by at least 25%.

And multitasking spills over into your personal time too. I call it the syndrome of continuous partial attention, the belief that something 'out there' on your smart phone is always more important than what is right here right now in front of you. The design of digital devices deludes you into thinking you can multitask. All that distraction diverting your energy and attention from your relationships, from yourself, from your life itself. Just think about it. Confucius once wrote that the man who chases too many rabbits catches none!

Workplaces That Simmer.

A recent review article on burnout in the Harvard Business Review (April 2017)  highlights the broader organisational challenges posed by burnout rather than attributing burnout to individual factors. The review article points to excessive collaboration with too many decision makers resulting in endless cycles of meetings and emails; up to 200 emails a day for senior executives, many of which may be unnecessary. That can equate to the average manager losing one day a week to email and two days a week to meetings.

Weak time management procedures, lack of individual autonomy, micromanagement and overloading the most capable employees all conspire to raise the burnout temperature.

Healthcare - A Potent Cocktail For Burnout

When you think about it, the modern workplace that is 'healthcare' so often promotes rather than protect against facilitates burnout among the carers.

The culture of perfectionism that scapegoats individuals who make mistakes instead of adopting a system wide approach to error prevention. 

Ever expanding clinical and non clinical workloads, ergonomic issues with technology, administration, lack of autonomy and the rise of defensive medicine are definitely in the mix. Add in caring empathic physicians, high achievers often with perfectionistic type personalities, lack of work life balance and a patient cohort with increasingly complex care needs and you can see that the ingredients for major burnout exist in abundance.

The warrior mindset that pervades medical training is another pervasive factor. This is the idea that if you can work 12 hours in a row your patients will be adequately well cared for. But when you work 24 hours in a row your patients will be better cared for. If you can work 36 hours in a row your patients will be even better cared for. 

Too busy being busy to even think about being too busy. Ask how we are doing, we will say great. We know what to do but the reality is rather different. So many doctors simply don't practice what they preach. On top of that, fear of reputation, the very real sense of shame, and stigma that still exists about burnout and mental health conditions even among medical professionals who really should know better. 

A survey done by the Royal College of Anaesthetists showed that of 2300 trainee anaesthetists it was found that 85% are at significant risk of burnout despite their young age. Factors identified included long work hours, fears about patient’s safety, working night shifts and long commutes to work. Many doctors are exhausted, frustrated and burned out. There is significant difficulty in maintaining meaningful relationships with family and friends.

There's a huge price to be paid for the consequences of burnout. Not just in terms of the physical, psychological, emotional and relational problems it causes for people or the estimated more than 125 billion dollars a year in healthcare spending in the US alone. But in terms of negative impacts on talent drain, productivity and employee turnover. Burnout causes serious collateral damage. 

Burnout Prevention

So how to stem the tide of burnout. While there is no 'one size fits all', here are a number of strategies that can help.

# Accept Reality, Take Stock & Reframe

Awareness precedes change. By this I mean carry out a personal audit, a record of all the places, events, situations, people, and processes that cause you to feel negative, stressed and helpless. Be honest with yourself, what gets measured gets improved. But it starts with you accepting the reality of how things are at the present time. This can be an ongoing list that you can add to over time. 

Can you do something to reduce the negative impact of each of these? What's the one small thing you can start to do today?

Perhaps you can reframe a situation using what I call a long lens (How might this situation look a year from now? Will it matter? Will I even remember it?). Or a reverse lens (how might this situation look from the other persons viewpoint).

Or perhaps cultivate a sense of growth from an experience. What about this event or experience can teach me something useful?

# Reduce exposure to digital devices.

Keep them out of your bedroom for starters and give yourself a digital free day each week. Unsubscribe from non essential lists. Multitasking is an illusion. Focus on one task at a time. Delegate where possible. 

Learn to say 'no' more often. Just because something is interesting or just because you are able to do it doesn't automatically mean you need to say yes. How will it impact on your existing priorities? Saying 'no' is the  shortest and yet often the most underused word in the English language. 

# Lifestyle

Get enough quality sleep (for most of us that's seven and a half hours a night). Eat good wholesome food that nourishes and fortifies you. Stay well hydrated. 

Take regular exercise which is such a brilliant brain tonic, breaking the tight hold negative stress can have on you, bringing forth a cocktail of mood boosting neurochemicals like serotonin and dopamine.

Move regularly throughout your day as well (I talk about the fifty minute hour, spending 10 minutes each hour standing up). 

# Alcohol

Alcohol can cause and exacerbate a number of burnout symptoms including anxiety, low mood and sleep disturbance. It can definitely make feelings of burnout worse. There is this illusion that alcohol in moderation is good for your health but this is a sweeping generalisation. Associated with at least sixty six adverse health conditions, less can definitely be more. An experiment I often recommend is to cut out alcohol completely for a month and observe how you feel. How is your mood? Your energy? This is often the best way to assess what impact alcohol is having on your mood and relationships including your relationship with yourself. 

#Workplace

Build workplace relationships, networks and sense of collegiality. Develop your own special interests. Spend as much of your time on those things you enjoy. Strive for more balance. Bring more recharge micro moments into your day, for example slowing your breathing, break time conversations, walking outdoors at lunchtime.

#Ergonomics

Ensure your workstation has been ergonomically assessed for you as an individual, especially your chair and computer. Consider a sit/stand desk whereby you can alternate your position throughout the day. Long term effects of poor posture and positioning at work can significantly exacerbate feelings of burnout.

# Invest in your own wellbeing. This is not just your physical health but building your psychological fitness and emotional wellbeing as well. Keep a journal, start a meditation practice. As little as eleven hours of meditation (ten minutes per day for three months) can structurally change your brain, expanding the areas for reflection, awareness, positivity and compassion while dampening down the stress response. 

Expressing gratitude and appreciation by writing down three things each day for thirty days that you feel truly grateful about can enhance your inner happiness and sense of wellbeing by up to twenty five percent. 

#Relationships

As social creatures, relationships are an investment in our wellbeing. Do you invest enough time in your friendships? Do you have people that strengthen and support you in your life? Making more time for your friends can be a terrific idea, particularly non-professional relationships. 

# Find Your Inner Ikigai

The word Ikigai is a Japanese term that implies a strong sense of purpose. When you know who you are and why you do what you do, purpose becomes a beacon of light guiding your values and can be highly protective against burnout. Spending time discovering or rediscovering your purpose can become a spark for renewed energy and a stronger sense of vitality. One of the features shared by Blue zones around the world (areas where people live long active engaged lives) is this strong sense of purpose. It really can become your secret sauce for a life of vibrant energy. 

# Resilience & Responsibility

As an individual you need the resilience skills to destress, think, feel and be at your best in today's fast paced world. This requires you to take individual responsibility - to know yourself, accept what you can't change and have the courage to change what you can. To become a leader in your own wellbeing. 

As a leader in your workplace and as an organisation, you need to resist the quick fix, faster paced work dynamics that foster burnout. Instead accept greater responsibility for workplace wellbeing. Show people that they are your greatest asset with more opportunities for autonomy, growth and flexibility with less micromanagement, multitasking agendas and box ticking bureaucracy. Embrace employee wellbeing and vitality as cultural values of your organisation and leadership team. Lead by example, as they say ‘show me don't tell me.’

# Seek Professional Support 

Don't go it alone. Consider cognitive behavioural therapy (counselling) with a trained therapist. It's good to talk. This can be invaluable. Talk to your family doctor or someone who specialises in burnout treatment and prevention. 

Burnout is real, burnout can affect anyone especially if you're a high achiever. Remember you're never alone. Burnout can be effectively treated and better still prevented. Your health is your greatest asset - treasure it. 

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