Read Time : 8 minutes
Thank you to the Belgian “Rehabilitation” team for their contributions on the subject: Nathalie VanDenBogaert, Jolien Hemelsoet, and Elvis Sausmikat.
Exhausted, drained, at the end of the line, weary, out of breath, constantly on edge, plagued by viruses, besieged by illnesses from all sides, a disrupted digestion, on the verge of divorce, estranged from loved ones, detached, numb to emotions and insensitive to others’, jaw tightly clenched, already kneeling for a while to hold on at all costs, sleeping pills and stay-awake pills, tension and heart pounding at its peak… the warrior collapses suddenly, struck down in their never-ending fight. The violence of the collapse is the culmination of what has been a foreseen downfall for months or even years.
This is, to use the trendy term, an illustration of burnout, a generalized exhaustion that gradually consumes its bearer. However, as Marie Peze points out (RFI Podcast, February 2023), “burnout is an all-encompassing term, a catch-all phrase.” She adds that it is now used to describe all kinds of life situations: parental burnout, school burnout, etc., and it has its extensions: bore-out (exhaustion caused by boredom at work) and brownout (loss of meaning and motivation at work). So, how can we see things clearly? What can be said that hasn’t already been said about burnout? What should we make of the surplus of information on the subject? How can we prevent our own potential burnout or that of a loved one or colleague? How can we be vigilant, take care of ourselves, and pay attention to others? Here, we will focus on burnout in its professional aspect, without excluding the impact of painful or traumatic personal events.
Given the vastness of the topic of burnout, our intention is to humbly provide you with information on the subject. In this first part, we will revisit its definition and manifestations, as well as the risk factors.
Definition and manifestations of Burnout (BO): How to define it?
Experts in the field indicate that burnout is a recent phenomenon in human history. Boris Cyrulnik (in “Se reconstruire après un Burn-out” by S. Bataille, p.5) describes it as “the result of our time, where behaviors have become chronically numbed by anomie and the loss of meaning in work.” He points out that its emergence is the succession of two phenomena in the modern era. Firstly, the Industrial Revolution in the late 19th century brought about an increased pace of productivity that requires a high level of energy expenditure from individuals. However, during that time, social rituals, family units, and collective structures served as protective factors, effectively separating the professional world from the personal world. Secondly, the rise of personal development since the 1980s has, in its flip side, contributed to the erosion of social bonds. Cyrulnik suggests that this emphasis on individual wellbeing has led to “a reversal of priorities: the pursuit of individualized wellbeing before the natural social constraint of solidarity and collective ecology.” Consequently, we have dismantled the safeguard represented by collective values in relation to overinvestment in work.
The term “burnout” was formalized by the American Herbert Freudenberger, who described it as follows in 1974: “As a psychoanalyst and practitioner, I realized that people are sometimes victims of fires, just like buildings. Under the tension produced by life in our complex world, their internal resources are consumed as if by flames.” As indicated by Legeron, Olie, et al. (Report of the French National Academy of Medicine on Burnout, 2016), French psychiatrist Claude Veil had already presented the concept of professional exhaustion as early as 1959. He depicted it as “the result of the encounter between an individual and a situation” and resulting from the “crossing of a threshold.”
The World Health Organization (WHO) considers burnout to be exclusively related to the occupational domain and specifies that it is not recognized as a medical condition in the reference classification (ICD-11, International Classification of Diseases). The WHO defines burnout in their 2019 report as follows: “Burn-out is a syndrome conceptualized as resulting from chronic workplace stress that has not been successfully managed. It is characterized by three dimensions: feelings of energy depletion or exhaustion, increased mental distance from one’s job or feelings of negativity or cynicism related to one’s job, and reduced professional efficacy.” In France, burnout is referred to as a syndrome of occupational exhaustion linked to work-related suffering and/or the effects of occupational stress.
What emerges from various studies on the subject is the profound imbalance that deepens in the relationship between job demands and resources available to the individual. Wilmar Schaufeli (2004, 2009), referring to the JD-R (Job Demands-Resources) model, specifies that this is the relationship between the demands of the job (pressure, workload, stress level, physical, emotional, and psychological demands) and the external resources (work environment and support: supervision, team, coaching, mentoring, opportunities for growth, etc.) and internal resources (family and social life, values, personality traits, resilience, rest time, etc.). Schaufeli highlights that the stronger the imbalance, the more exhausted the person becomes and the fewer resources they have to adopt an effective coping strategy, thus reinforcing their exhaustion. This sets in motion the cycle of burnout. If left unregulated or unaddressed, the imbalance will impact all areas of the person’s life. From a clinical standpoint (HAS, 2017), burnout can manifest with emotional disturbances (anxiety, irritability, hypersensitivity, or emotional numbness), cognitive impairments (attention-concentration problems, memory difficulties), relational difficulties (aggressiveness, social withdrawal), motivational problems (disengagement), as well as somatic symptoms (lower back pain, fatigue, sleep disturbances, musculoskeletal disorders, headaches, gastrointestinal issues, etc.) and can also lead to addictive behaviors.
Risk factors: What contributes to the development of burnout?
In small doses, stress can be a motivator, helping individuals push themselves and overcome challenges. However, in the medium and long term, the accumulation of stressors significantly depletes available resources and can lead to burnout in the professional sphere. In his theory of the General Adaptation Syndrome, H. Selye (1956) describes the body’s response to stress in three stages, each of which induces specific physiological and hormonal reactions. The alarm phase is characterized by the body preparing to react to stress or flee. During this phase, catecholamines are released to mobilize the body for action. The resistance phase occurs when the stressor persists, and the body mobilizes glucocorticoids to cope with the ongoing stress. The body attempts to maintain stability and withstand the effects of the stressor over an extended period. Finally, the exhaustion phase is reached when the stress becomes chronic or overwhelming. During this phase, hormones surge uncontrollably as the body’s regulatory mechanisms become overwhelmed. The body is no longer able to effectively regulate these hormones, leading to a state of exhaustion.
Chronic stress in the workplace can have detrimental impacts on both the organization, such as increased absenteeism, decreased productivity, and high turnover rates, as well as on employees themselves, leading to emotional distress and physical symptoms. Emily Fournier (“The Effects of Psychological Stressors in the Workplace,” March 2023) provides an overview of the effects of psychological stress on employees and suggests possible responses to address them. Like a spiral, heightened stress gradually and unknowingly takes hold, creating an environment where burnout can take root. According to neuropsychologist Cathy Assenheim (interviewed by Bénédicte Beauloye, 2023), burnout is a neurological and hormonal dysregulation of our adaptive resources, which are managed by two glands called the adrenal glands. In the initial stage, the nervous system compensates and boosts itself. Individuals experience a constant state of tension, functioning almost like robots with their brains continuously running. However, this nervous crutch eventually gives way and fails.
The nervous system works in collaboration with hormones, which are neurotransmitters that facilitate the connection between the mind and the body. Cortisol is the hormone responsible for providing energy, and when it is no longer produced, a person may feel completely drained. There are also imbalances in neurotransmitters that are associated with mood and anxiety, leading to symptoms resembling depression. One feels exhausted, wanting to isolate oneself and withdraw from social interactions, and experiences episodes of nervous anxiety. These symptoms may resemble signs of depression, while the underlying cause is actually hormonal.
In addition to chronic stress, individual and collective factors can contribute to the development of burnout (“Guide to Burnout Prevention,” DGT, 2015). On an individual level, one factor is the relationship that each person has with their work, particularly the centrality of work in their life and the sense of commitment. Collective factors include work demands (intensity and duration of work) and job requirements (emotional, physical, and psychological), lack of autonomy, deteriorated social relationships, conflicts in values and impeded work quality, pressure for increased profitability, and job insecurity.
To these observations, three new risk factors that further increase the risk of burnout have emerged in the early 21st century: telecommuting and the proliferation of Information and Communication Technologies (ICT) associated with constant multitasking. Regarding telecommuting, currently and especially after the COVID-19 pandemic, its full or partial implementation has offered numerous benefits such as reduced commuting time and the ability to manage daily constraints while working in a comfortable environment. However, there is a downside, as it has been observed that telecommuting can contribute to a decrease or even a complete loss of interpersonal exchanges due to the reduction in so-called “interstitial” times: the time spent at the coffee machine, a few words exchanged at the photocopier, and the sacred time of lunch with colleagues. These times have the benefit not only of providing breaks and interruptions in relation to production activities but also of fostering social connection and support, as described by B. Cyrulnik. ICT now allows us to have multiple communication networks: emails, Teams chat, and text messages that constantly intertwine alongside a video meeting (which has already started)… Added to this is “task switching,” facilitated by the use of multiple ICT tools, and burnout is not far away. Hyperconnectivity and task shifting, initially appealing and even exhilarating due to the impression of being able to be on top of everything and respond to all demands, expose the brain to constant overstimulation, as highlighted by Mr. Peze (RFI podcast, 2023): “It’s a breathless work, without breaks. We are constantly being solicited, it’s non-stop.” In the long run, euphoria can give way to exhaustion because continuous multitasking exacts a high cognitive cost in terms of attention and concentration, creates mental fatigue, and leads to a loss of efficiency (Pauline Allione, “How to Juggle Tasks Without Coming Close to Burnout?” 2023).
Conclusion:
Burnout doesn’t only happen to others; it can happen to anyone, in any job position, and at different stages of a professional career. A change in one’s career path, a complex or poorly supported skill development, changes in the organization, and the accumulation of stressors that individually may not have significant consequences but, when combined, can push anyone towards exhaustion. Recovery from burnout requires a structured process with steps to be taken, without rushing through them to avoid relapse, and with proper support. In a follow-up article, we will provide insights into possible treatments for burnout and key prevention strategies.
With that, I suggest you take a break from this article and take some time for yourself. In short, enjoy a good rest!
References:
Podcast RFI / Interview with Marie PEZE and Jean-Claude DELGENES https://www.souffrance-et-travail.com/magazine/burn-out/le-burn-out-est-il-reconnu/
BATAILLE, Sandrine (4th Ed. 2022). Se reconstruire après un Burn-out : les chemins de la résilience professionnelle [Rebuilding after Burnout: Paths to Professional Resilience]. Dunod : Paris.
Freudenberger HJ. Staff burnout in Journal of Social Issues, vol. 30, 1974.
LÉGERON P., OLIE J.P et al. Rapport de l’Académie nationale de médecine sur le Burn-out [Rapport from the National Academy of Medicine on Burnout] (2016) https://www.academie-medecine.fr/wp-content/uploads/2016/02/26-fev-2016-RAPPORT-ACADEMIE-Burn-out-V3.pdf
WHO website/Burnout classification, May 2019 report https://www.who.int/news/item/28-05-2019-burn-out-an-occupational-phenomenon-international-classification-of-diseases
Schaufeli, W.B. & Bakker, A.B. (2004) Job demands, job resources and their relationship with burnout and engagement: A multi-sample study. Journal of Organizational Behavior, 25, 293-315.
Schaufeli, W.B., Bakker, A.B. & van Rhenen, W. (2009). How changes in job demands and resources predict burnout, work engagement, and sickness absenteeism. Journal of Organizational Behavior, 30, 893-917.
Fiche HAS, Repérage et prise en charge cliniques du syndrome d’épuisement professionnel [HAS Fact Sheet, Clinical Identification and Management of Professional Burnout] (2017) https://www.has-sante.fr/jcms/c_2769318/fr/reperage-et-prise-en-charge-cliniques-du-syndrome-d-epuisement-professionnel-ou-burnout
SELYE, H. (1956). The stress of life. New-York : McGraw-Hill.
The Effects of Psychological Stressors in the Workplace, Emily FOURNIER / Workplace Options https://www.workplaceoptions.com/effects-of-psychological-stressors-in-the-workplace/
Le burn-out ne serait pas uniquement psychologique : « C’est aussi une maladie du corps », Interview de Cathy Assenheim par Bénédicte Beauloye [Burnout is not only psychological: “It is also a physical illness,” Interview with Cathy Assenheim by Bénédicte Beauloye] https://www.rtbf.be/article/le-burn-out-na-rien-a-voir-avec-le-psychologique-cest-une-maladie-du-corps-11150587
Guide à la prévention du Burnout (2015), produit par la DGT (Direction Générale du travail) en collaboration avec l’ANACT, l’INRS et le Ministère du travail [Guide to Burnout Prevention (2015), produced by DGT (General Directorate of Labor) in collaboration with ANACT, INRS, and the Ministry of Labor] https://travail-emploi.gouv.fr/IMG/pdf/Exe_Burnout_21-05-2015_version_internet.pdf
Comment jongler entre les tâches sans frôler le Burn-out ? Pauline Allione / Welcome To The Jungle [How to Juggle Tasks Without Coming Close to Burnout? Pauline Allione / Welcome To The Jungle] https://www.welcometothejungle.com/fr/articles/jongler-taches-eviter-burn-out
