What is burnout? And how do culture, stress, and emotional exhaustion play a role in the lead up to experiencing burnout?

What’s the worst advice you’ve ever received? Is it avoid stress? Because that’s a real doozy.

With bills to pay and life to live, how in the world do you avoid stress? Is there some kind of pause button you can hit on this thing called life? And if there is, is it the one that reads DON’T PANIC?

It may come as no surprise that stress, burnout and post-traumatic stress disorder (PTSD) are all related to one another.

Stress can be useful, of course. It helps us survive by sending extra resources in the form of cortisol to our muscles and focusing our brain, as it does in the fight or flight response.

The problem is when the fight or flight response has no end and our glands keep receiving cortisol. It’s as though we are always being chased by a saber tooth tiger hell bent on making us dinner. The response is supposed to last long enough for us to survive the chase. It’s not supposed to be triggered by deadlines and traffic jams. Fight or flight is not meant to aid us in navigating our daily lives.

The fact is, however, that many of us cannot avoid stress.

It’s there in the macro and micro aggressions faced by most women, and even more so for women at the intersection of other identities that have been marginalized. Stress is a constant for people who do care work,  for those who do customer-facing work, and for those who struggle to make it through the day without proper training and resources.

And when it goes unchecked, it can lead to burnout.

Burnout

In their TEDxLondonWomen talk, clinical psychologist Dzifa Afonu tells us that social workers are likely to experience burnout in just eight years adding that “91% of social workers report high to moderate levels of emotional exhaustion.”

Afonu points out what should be obvious to us when we hear these numbers: burnout is not an individual issue. It’s organizational.

And, wow, has the pandemic ever been a forest fire! Whether it’s the lack of human contact that is causing strain or an excess of human contact in tight spaces that’s putting us on edge; whether it’s work or home, personal or political, most of us have felt the extra pressure of making it through the day.

For those workers who work in care professions, the pandemic has accelerated the pace of burnout.

On the Frontlines of Care

“There’s this idea that those who give support are full cups and need to empty all of their resources into the empty cups of the needy.”

Dzifa Afonu

It is not simply the long hours and the feeling of helplessness in the face of an unknown disease that cause harmful stress to those in the care professions. It is more. People on the frontline are fighting an actual war against the pandemic. They have suffered casualties, buried co-workers, and made impossible decisions.

And what is the message we’ve sent to frontline workers in return? Well one of them is that we will clap for you, but we won’t make sure you have the resources to do your job properly or even, yes EVEN, to survive your job. Afonu says:

“Our images of the heroic form around the idea of people who sacrifice their needs for the good of another. We use the terminology of frontline worker, it comes in military language. And it’s like we have this expectation that workers are in combat and need to be willing to put their lives on the line for others.”

Dzifa Afonu

The failure of leadership to prioritise the lives of people doing the hard work of actually making our society run and caring for us has caused moral injury. A moral injury occurs both when we cannot act based on our own morals and values and when we are not treated according to our morals and values .

Moral Injury

In her commentary in the journal BMJ Leader, Dr. Suzanne Shale adds another dimension to the notion of moral injury. That’s the injury done to people who have been mistreated and misled. Some of it at the hands of the care industry itself. Some of it by poor leadership.

Shale reminds us that eliminating the spread of COVID has required us to give up key aspects of our own lives in order to save others. Many of us have had to sit home while a loved one dies alone, celebrate milestones via video-conferencing, or even simply give up travel and festivals.

Meanwhile, many of our leaders have flaunted these same regulations.  This has done a moral injury to us and to our trust in their capacity to lead us. It’s opened the door to conspiracies, lies, and misunderstandings.

When our leaders mislead us and lie to us, we are injured.

When we marginalise and make vulnerable people most likely to be harmed by COVID, we injure and are injured.

The COVID pandemic has resulted in long lasting wounds that will require repair: moral repair.

“In COVID, we see such an example of how our models of care fail to take care of the people that care, and the consequences, they’re terrible for all of us. Even when faced with urgent situations, people are not supported and given the structures that they need. We’ve also seen in COVID, an example of just how interconnected we are. When one person in the world becomes sick, we’re all affected. Any gaps in our public health services can have tragic global effects.”

Why Do Good People Do Harm?

Afonu’s decades of experiences in the care profession, led them to ask one central question:

‘Why do good people who can be so humane to each other, and to their families, end up treating people who are vulnerable as if they are products rather than people?’

Dzifa Afonu

That question led to other questions, which Afonu addressed  in their TEDxLondonWomen talk. Let’s look at them:

  • Why are we treating burnout as an individual issue, rather than as an organisational one?
  • When does professional distance cross the line into dehumanisation?
  • How can we care for people and then send them back into a world that doesn’t care?
  • Can we dissolve the artificial boundary between those who help and those who are helped?
  • ‘Why do we disconnect? Why do we ignore our own needs? And how can we be more present?’
  • How can we reimagine what it means to be a hero?

Signs of Burnout

You might be wondering what burnout looks like? Well, you don’t wake up one day and find that you’ve caught burnout like you might catch a cold or flu. Instead, the symptoms accumulate until they are unbearable. Things to watch out for include:

  • Frustration
  • Feeling less effective
  • Unquenchable exhaustion
  • Quick temper
  • The sense that others are against you

What Can We Do?

Well, what can we do? Life is stressful.  And yet there are ways to address the things that cause burnout.

Close the stress cycle

Personally, we can close the stress cycle. In their book Burnout, Emily and Amelia Nagoski write that we can put a stop to the fight or flight response through vigorous exercise or through a relaxation technique called progressive muscle relaxation. Search for it and you’ll find a bunch of how-tos.

Model good boundary setting

If we are in positions of power, we can model good boundary setting and make sure employees have the resources and training they need to do their work.

Redefine heroism

Importantly, we need to, as Afonu says, redefine what it means to be heroic. Let’s let them have the last word:

“We really need to start reimagining what it means to be a hero. Heroes ask for help when they need it. Heroes fight for more just systems that fully resource those who need support. Heroes take time off. Heroes prioritise rest, healing and resourcing themselves. Heroes don’t have to strive alone, but are surrounded by communities that value them and the work they do. There are heroics in both giving and receiving care. In our moments of need and vulnerability, it takes courage to truly receive care. We all need that courage if we’re ever going to imagine that anything else is possible and to truly reimagine what it means to give and receive health and care.”

Dzifa Afonu

Go now. Watch the entire talk. We’d love to hear your ideas for redefining heroism.