What is Burn-out? 

Let my start my article with a little story.

A collegaue of mine works at Skyguide, the air traffic control in Kloten and told me the following about an authentic radio communication between the pilot and the flight safety

Tower: „Do you have problems?“
Pilot: “ I have lost my compass.“
Tower: „It seems to me as you fly, you have lost all the instruments.“

The congruence between this story and a person who is in burnout is, that the person in a burn-out has somehow also lost the orientation, the inner compass. He needs a new adjustment of his life, a new guideline

I will talk about the following points

  1. The symptoms of the Burn-out syndrom
  2. Explanation of Burn-out syndrom: The disbalance in Energy
  3. Who has a particulary risk?
  4. How can I recognize burnout? The 8 phases of burn-out
  5. The burn-out test: Online Stress Profile OSP
  6. Discussion
  7. Stress and Neurobiology

It will be a big challenge to hold this speech in English, I never have done it before. Because my English is not so elaborated, I count of your understanding.

 1. The symptoms of Burn-out syndrom

The Burn-out Syndrom has 3 dimension, mostly in combination.

First Depersonalisation, its called the client related burn-out.  The person is indifferent, cynical, distance to clients and/or employees. It influences the interaction, the contact to others.  Example-item: it’s increasingly hard for me to get and to be in touch with the customer or employees.

Second emotional exhaustion, its called the personal burn-out. The person is irritable, strained, has weak drive. It influences the indivdual mood and state. Example-item: I feel totaly out of my job, have no fun and interest any more.

Expierence of failure, its called the task-related burn-out. The person is ineffecitve, has hyperactivity and feels a lack of meaning. It influences the performance, the task. Example-item: I have always less a feeling, that I really help others or do something essential

Maslach burn-out inventory

2. Explanation of the Burn-out Syndrom: The disbalance in energy

A common model for the explanation of burnout, especially in companies and in management is the concept of imbalance between demands and resources, short-ERI (effort-reward imbalance model) as you can see in the slide. Based on this model is an an appropriate measuring instrument developed, the questionnaire for the detection effort-reward imbalance (ERI questionnaire ). If you like, you can do it yourself by using this link: http://www.workhealth.org/UCLA%20OHP%20class%202004/ERI%202004.pdf it is free of cost.

Examples of scales and items of the ERI are:

o „I have constant time pressure.“
o „I carry a lot of responsibility.“

o „I am often disturbed at work.“
o „In recent years, my job has become more demanding.“

o „I’m not treated by my supervisor/boss with the necessary respect.“
o „By facing difficulty I do not get adequate support.“
o „I am often treated unfairly.“
o „My professional future is uncertain.“

Effort imbalance modell

The imbalance between effort and reward, according to ERI is often accompanied by excessive Commit (over-commitment), where the individual  sacrifice himself  literally. This is reflected in statements such as:  „When I wake up I think of the problems that await me during the day.“ In addition with sleep disorders and insomnia.

I like this energy-based-model more instead of the work life balance concept. Because burn-out is not a quantitativ, but a qualitativ problem. Not the amount of hours you are working is determining if you have the risk to get a burn-out, the qualitiy of work you are doing is crucial.

If you have a good  qualitiy of work  by doing something senseful, using your talents and getting gratification you can work more than 8 or 9 hours daily.

If the energy you invest in your work is in balance with the return on investment by getting back satysfaction, gratification (material und inmaterial) and high reward, you never will burn-out, because you are not running out of energy, you are in a energy balance.

I will show you my concept of positive and negative stress, with the difference between  to be in the stretch- or stress-zone. 

In the stretch-zone, like the rubber-band in fitness, you can close the gap between your competences, knowledge and experience which you have already and what is asked for in the new challenge, reach the goal or be sucessful in new job. In this case you will have a personal development with more self-consiousness,  self-esteem and knowledge.

If the gap is to big between your competence portfolio and what you have to do and you can not close it, then you fall in the stress-zone with all negative effects. Tension in your body, connected with pain.

The individual ability to handle stress in the job depends on his personal resilience (resistance). The following personal aspects reduce his personal resilience and can promote burnout:

  • Neuroticism: characteristics are such as anxiety, lack of self-respect, tendency to irritation, worry and depression, tendency to compulsively, unstable self-esteem
  • Striving for perfection: the person often set high goals for himself and has a problem to compromise. It has a lasting impact on his action planning and assessment.
  • Helper-syndrome: An attempt failed donation and failed attention in childhood now to compensate through unconditional social activity. The helper is giving the attention to others that he wants to receive himself. People with the helper syndrome try to stabilize their unstable self-esteem through the sacrifice of a great task and the associated gratefulness of many recipients who get the help.
  • High ambition: people whose self-esteem is only based on their job performance show often a pathological addiction to success. This is mostly influenced by parental education, namely if high regard and acceptance, the feeling of love was directly dependent on the success of and performance in school during  in childhood.
  • Special personal shortcomings: poor education provokes failures and the inability to set other limits, can also promote a burn-out

As a starting point for the prevention and treatment of this syndrome results from this model, the restoration of equilibrium. These specific competencies, such as self-regulation, self-management or implementation skills are necessary.

 3. Who has a particulary risk?

People with the so called „A-type“ behavior have an increased risk of a burnout or a cardivascular disease, such as to suffer a heart attack. A-type individual tend to behave competitively, lead a sucess-oriented lifestyle and work under time pressure. Especially people who have a verry committed approach with a high emotional involment in their task, have an increased risk to develop an burnout. In addition to the indivdual disposition is also a company culture where not the personal and emotional  commitment is appreciated, but only the result, the outcome. This context can lead to big frustration and disappointment.

4. How do I recognize burn-out? The 8 phases of burn-out?

Against 35% of employees in Switzerland suffer from chronic stress, 4% are already in a burnout. This  facts about stress are puplished in the latest study, edited by the State Secretariat for Economic Affairs SECO 2010. Since 2003, the trend is massive increasing.

What is leading to a burn-out?

A lack of relaxation and to much stress. We have more and more information and at the same time less and less time to process it. Today the constant readiness is expected to communicate via e-mail, SMS or phone. One is constantly online. It lacks the time to think in peace, one is always in a functional state. Sleep problems increase with sleep difficulties and the deep sleep phases can’t be reached anymore.  Deep sleep is necessary for relaxation so that the body can produce immune cells that protect the organism against diseases and viral infections.

The lack of movement and an unbalanced nutrition prevent the self-cleaning process of the body, he is disturbed by burn-out.

Does it give professional groups which are particularly vulnerable?

Previously, the burn-out, called also the fatigue syndrome was a phenomenon in the helping professions such as teachers, social worker , nurses  and doctors . Today, it affects nearly all professions and industries. The trigger is not too much work, but often the large discrepancy between the goals, whether they are prescribed or self-set and the individually available resources, to achieve this. The disbalance of energy as I mentioned before.

Who scored no results in his job, but is dependent on circumstances that he can’t influence gets into a crisis of meaning, can’t find fulfillment because the energy balance is no longer correct. The energy balance is critical. This means that much of the energy is put into the work and no or to less energy is coming back.

When the energy is in balance, then the amount of work plays a minor role. Burnout develops normaly in the context of work and has, in contrast to depression, no genetic component.

Are there warning signs?

The development of burnout is a gradual process that makes typically the following warning signs noticeable:

1. Concentration problems:
It is harder to think and to provide the normal services. In the communication, misunderstandings accumulate.

2. Sleep disorders:
Long lying awake before falling asleep or frequent sleep interruptions prevent nocturnal rest.

3. Disturbance and memory ability:

For a moment it can be black before the eyes. Beside of memory lack, small dropouts in thinking happens.

4. Emotional instability:
The feelings are hard to control. They vary between crying and sudden fits of rage.

5. Tension pain:
Physical complaints are piling up, e.g. Palpitations, high blood pressure and muscle tension in the back and neck.

6. Failures:
The available time is no longer enough. Achievements are possible only with extreme efforts. Mistakes happen more often.

 7. Thoughts running in a circle:
It is difficult to make decisions, the head feels empty to, routine is still possible, but no more productive thinking.

8. Regeneration is no longer possible:
In the final phase, in the manifest burnout, each activity is exhausting. Sleep is greatly disturbed. Beside of sweating,  tinnitus (hearing loss) can happen, and nausea also can occur.The burn-out test: Online Stress Profile OSP

If you want to do a test to check your personal stress-profile and to see if you are in the green, orange or already red zone, please send me an e-mail. I can mail you an assessment to do it. It cost 120$.