The Martrydom Baked into Helping Professions Blocks Burnout Prevention

I sat down with Shaina Siber, LCSW of AFFIRM Mental Health recently to talk about an affliction that plagues helping professions: burnout and burnout prevention. We discussed that there are a lot of reasons that individuals working in the therapy realm as well as healthcare as a whole might work to (and beyond) the point of burnout, and some of the reason is the very essence of what brought them to the professions originally: wanting to help people and find meaning in their work. Messaging around duty and commitment to colleagues as well as patients can keep a worker working beyond what feels right to them. Burnout prevention means being realistic about what duties and requirements are part of the workplace culture.

What Burnout Actually is Beyond Being Tired

Burnout is a phenomenon that many have experienced but it is a) sometimes hard to recognize and b) sometimes hard to define. Shaina describes it as more than exhaustion. She describes that the WHO notes that it is a condition that originates in the workplace, while naming the consideration that it is also exhaustion, energy depletion, growing distance or cynicism around one’s work, and a drop in professional efficacy. She notes that that last element often is one of the last identifiers to show up. She describes that her own experiences of spending years in clinical work have helped to add additional context: burnout is what happens when someone tries to function or conserve energy under chronic occupational stress. It’s an adaptive attempt to keep meeting demands, but onte that ends up damaging mental, physical and even relational health over time. She notes that 3 out of 4 workers may experience burnout at some point.

Christina Maslach’s 6 Systemic Drivers of Burnout

I noticed in Shaina’s Book, Using ACT and CFT for Burnout Recovery, she cited Christina Maslach’s research on burnout, which include the following:

1. Work overload (expectations, volume and pace that are unsustainable. Working 55 hours a week raises risk of stroke, heart attack and even mortality.
2. Lack of job autonomy: Not having meaningful influence over how, what and when you do at work. More autonomy is protective.
3. Lack of Reward: Both recognition and compensation. She describes that burnout conversations have to include pay conversations, because no corporate wellness program can make up for living in poverty. Rewards aid in burnout prevention.
4. Lack of community. People experiencing support, trust, and belonging at work tend to have some resilience. ( I can attest-despite challenging conditions in my earliest work settings, the connections I made with a large group of other associate-level clinicians made the job feel manageable!)
5. Lack of fairness. Bullying and Harrassment sit at the extreme end, and she notes these raise burnout risk even for people who witness them, ot just direct targets. Favoritism and lack of transparency fall under the same umbrella.
6. Mismatch of values. Work misaligned with a person’s deeply held values, even resulting in moral injury. An example she and I talked through more recently was a therapist who provided ethical trainings to non-therapist business owners. The therapist described that this was rewarding financially but it resulted in moral injury when the lessons weren’t applied but the trainees would state that they had been trained on ethics by the therapist.

Understanding the components that can lead to burnout can help us examine what is necessary to start a road to burnout prevention and healing.

The steps for Burnout Prevention: Starting with Creating a Compelling Vision

Shaina tells us that burnout keeps folks on autopilot. She describes it as being stuck in autonomic response loops, where we are behaving in ways that avoid threat rather than moving toward meaning. She tells us to get granular with developing a life worth living, or in this case a career worth having. Start with the end point and reverse engineer the visuals of what you’re actually building. This includes: what you want to achieve, including money, and what “enough’ actually looks like. How you want to feel on a daily basis. What kind of relationships you want to have. What kind of impact you want to have on the people around you. What you want your relationship with work to look like, and what your life looks like once you leave it each day.

She recommends tying your work to your larger vision. Figure out what you want, why you want it, and keep the vision in mind in your daily experiences of work.

This episode was important not only as a helping professional helping professionals who experience burnout but also for therapists trying to get out in front of their own burnout prevention.

Check out the full episode on Why Burnout Prevention is More than Self Care