Burnout and Psychotherapy
Dr Jonathan Haverkampf
Burnout is largely a product of the society we live in and our interactions with it. The more we are in communication with others, the more messages we receive and send, the higher is the chance for collaborative success, but the greater is also the risk of burnout, especially if we do not know what goal we are chasing or why we are doing our daily routine. The problem is most often not that the world is faster or more interconnected, but that many people do not know the reasons they are going after their daily for. The solution for burnout has to do with meaning, but especially with true values, interests and aspirations. The road to get there is through communication, as, for example, in a psychotherapy.
Burnout was probably rare in stone age societies, and it takes highly artificial conditions to induce burnout in animals. While it is possible to induce burnout symptoms in lab rats when they are exposed to persistent stimuli causing high levels of negative stress and arousal, this is unlikely to occur outside the lab. However, under these conditions the animals show symptoms that are similar to those of people suffering from burnout. They have low tolerance for even minor stimuli, such as noise, and seem to experience helplessness and high levels of psychological distress. Their life expectancy is reduced, they no longer eat regularly, often lose weight, show signs of exhaustion and after a while suffer from bodily conditions that ultimately lead to an early death. They seem to have learned that they are helpless and that their avoidance behaviour is ineffective. Like people they seem trapped in a hopeless situation, but, unlike humans, they really are.
Burnout is often approached from the wrong angle. It is not really that we have to change what we or how we do it, but evaluate the reason we do it for. I have seen many patients who went through life without thinking about their values, interests and aspirations. One might think that it is a sign of genius not to have to mull these questions, but this is actually far from the truth. Many people of genius struggled with such existential questions on a daily basis. The only difference is that many people do things on a daily basis that do not bring much happiness and enjoyment, which increases the risk for a number of psychiatric conditions, among them burnout. Unfortunately, many people think they cannot afford to think about this question because it might change their life dramatically. But this is not the objective of knowing what you truly value and are interested in. The point is to make better decisions in the future.
Being a care provider or teacher in a less than ideal environment often leads to burnout if one has a need to ‘give it all’ and ‘care for others as if this were the last day’. Although burnout can occur over time in a variety of situations, it is mainly triggered by events in the workplace or in a relationship. The external cause is usually a prolonged external stressor, such as a mobbing situation or an unhappiness with the current job or relationship. The internal causes are often preconditioning personality aspects, such as the inability to say ‘No’ or to keep an appropriate distance to other people’s problems. It almost always requires both, the external and the internal factors, to lead to a full-blown burnout. If I feel secure and confident with myself, I might just leave the job where I get mobbed and so avoid burnout. On the other hand, working in a loving and caring environment will probably not lead to burnout, even If I cannot say ‘No’.
Burnout often requires professional help because it comes with the sense of hopelessness and helplessness, which tends to make ‘self-help’ difficult. Burnout has to be solved through communication, which no longer works effectively. Patients with burnout have lost touch with themselves and others. Humans need communication with meaningful messages, that they can use to regulate themselves and change the world around them. In the case of burnout one often observes a freezing of the personality to become rigid and brittle in the face of change, as well as the fear of potential fragmentation and disintegration from it. The self is imprisoned and communication dies down because any change or influence seems extremely stressful.
There are a few central steps that need to be taken, whether one tries to deal with the issue oneself or works with a professional, all aim at a more flexible and open communication that allow the individual the freedom to look at what it is really important to him or her:
First, it is important to realize that one is experiencing an actual or potential burnout situation. Without this acknowledgment it is difficult to face the resistance not to touch one’s routines, thought and behavioural patterns. It also helps with the aversion to change. There may be fears that one may have to make undesirable changes, but doing almost anything that creates extra breathing space to think and reflect and avails room for change, effectively counters the sense of hopelessness and helplessness that is central to burnout.
Secondly, assessing one’s values, needs, wishes, dreams and aspirations, and having a vision of what life might look like in the future paves the road to successful change. It also means assessing and analysing the feelings that are associated with thinking about the future. Depressed thoughts and negative emotions are relatively common in burnout and thinking about the future can seem meaningless or even painful. Assessing one’s situation in the safe environment of a therapy session does not have to mean immediate change, but it helps to fight the hopelessness and helplessness that are associated with burnout.
Thirdly, since burnout manifests in the interactions and relationships we have with others, it requires looking at one’s own communication patterns and how best to respond to someone else’s unhealthy communication style. How we interact with other people is shaped by our past life experiences, and if they have not been so good, they can make us fearful even in the present. If your father was given to unpredictable emotional outbursts, you may be fearful in situations with your boss, a (male) authority figures. Since the father’s behaviour was not predictable, you feel helpless. Feeling helpless and hopeless, you are unlikely to reflect on how to defend yourself effectively and on understanding the dynamic between you and your boss, which could help both of you. The world has become an unpredictable place, you are on constant alert at the workplace and this will ultimately lead to burnout when the exhaustion takes its toll. Maintaining the space to take a step back and reflect on the situation can prevent this.
Building new communication patterns requires insight in the present ones, which can be developed through reflection in the therapy sessions. Good communication patterns and a sense of knowing where one stands and where one would like to go next are affective antidotes to burnout. Change should occur in steps that can be planned and reflected on. The future does not have to be mapped out in any detail, as this deprives us of the possibilities that are not yet known to us. But one should sort out one’s fundamental values, one’s needs, and the things one would be unwilling to compromise on, as well as have an idea in which general direction the journey should go next. A lack of sense of direction makes one more susceptible to stress, pressure and burnout. Have the courage to visualize the future.
Fourth, it is important to determine the relationships and things which are helpful and which are not. This may not always be easy to tackle because of fears that this could lead to people turning away or even loneliness. But there is no reason to threat it, because it really means taking control of one’s social life rather than losing it. Meaningful change is good, hasty decisions almost never.
Fifth, as you become clearer about yourself and your interactions with the environment and your communication patterns improve, you will gain trust in your ability to shape your environment. You will also notice a greater attraction on other people. The negative voice in the back of your head telling you that you don’t know what you are doing dies away. As you gain greater trust in yourself, you have more faith in your internal compass, and this effectively prevents anxieties, burnout and a number of other conditions. This will also bring greater clarity about the values and interests that are important to you. This makes decisions easier and helps you orient yourself towards the future.
Self-confidence is best built by not thinking how to get it, but doing the things you would do if you had it. This requires thinking about the things you like to do, as well as your values and aspirations. What challenges you in a positive way? What gives you pleasure? Achievements only improve your self-confidence if they resonate with your values, needs and aspirations. Many people are afraid to look deep down into themselves to find answers, not necessarily because they assume there is something unpleasant, but because they fear they might encounter a void. This is why it is helpful thinking about one’s values, needs and aspirations, because they are there no matter what.
Sixth, taking new perspectives on the world and developing greater openness to the good things in life develops automatically if you do not give up and get the help you need. Take a new look at the world and be open to what it tells you. Burnout is a closure of the mind, and the best antidote to it is to open one’s eyes and engage with oneself and the world.
© 2012, 2016 Christian Jonathan Haverkampf. All rights reserved.
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This paper is solely a basis for academic discussion, no medical advice can be given and no medical advice is given. Always consult a professional if you believe you might suffer from a medical condition.
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