As lockdowns start to lift, we have a rare opportunity to address burnout on a systemic level – and make sure everyone’s included
IT STARTS WITH a lack of energy, which gradually builds into a sense of exhaustion. You feel apathy towards your job when you previously took pride in it. Cynicism sets in. Your productivity drops, or at least it feels that way. You put in more time and effort to try to compensate, but you don’t feel the sense of accomplishment you used to – you just feel even more tired. You’re burned out.
More than a year-and-a-half into the Covid-19 pandemic, burnout is having a moment. Having initially scrambled to adjust to the sudden upheaval of the workplace – made to switch to remote work with little or no preparation, or deemed an essential worker and asked to continue business-as-usual in highly unusual circumstances – we’re perhaps only now really starting to feel the repercussions.
When the pandemic first hit, says Torsten Voigt, a sociologist at RWTH Aachen University in Germany who has researched burnout, everyone was so busy trying to adjust and keep things moving that we didn’t have time to worry about longer-term consequences. But more than a year on, and with lockdowns starting to lift in some regions, this initial expenditure of energy may be catching up with us. “Now, when we take a deep breath, some will realise that they potentially have given too much at that point and that they need a break,” he says.
But while it may be little comfort to those suffering, there could be an upside to our current burnout reckoning. It presents an opportunity to reconsider our relationship with work – not just on an individual level, but on a societal one.
Because while burnout may be gaining greater recognition, it’s not applied equally. We tend to think of burnout as affecting doctors, teachers, office workers. “I’m not sure if, say, a hairdresser or a car mechanic would say they are burned out,” Voigt says. It’s not that people in these roles don’t experience burnout, he says – but discussions of burnout often seem to be centred on occupations associated with a certain educational or socioeconomic level. You don’t often hear of cleaners, or supermarket workers, or people balancing three jobs as being “burned out”, even though most of us would say their work is objectively harder. “They basically don’t even have the luxury to talk about burnout,” Voigt says.
The world in which burnout as a concept was initially conceived likely looked quite different to the one we live and work in today. The gig economy, zero-hours contracts, automation, even smartphones, have transformed the way many of us work. Our understanding of burnout – and how to address it – may need to evolve too.
BURNOUT IS AN intuitive term that’s both easy and difficult to define. On the one hand, it’s a clear metaphor that describes how a lot of people feel when they lose energy and motivation at work. But it is not a medical diagnosis, and lacks the kind of tightly-defined symptom list you might expect for a physical or mental health condition. The World Health Organisation includes burnout in its International Classification of Diseases (ICD) only as an “occupational phenomenon”, and defines it as “a syndrome conceptualized as resulting from chronic workplace stress that has not been successfully managed.” Some researchers question whether burnout is even a distinct phenomenon, or if it might overlap with depression.
Originally, burnout was researched and discussed largely in the context of healthcare workers. The origin of the idea is usually credited to Herbert Freudenberger, an American psychologist who used the term to describe what he saw among employees in the “free clinic” he worked at, which offered medical services to underserved communities, such as people with substance abuse issues. In 1974, Freudenberger wrote about “staff burn-out”, describing physical symptoms including fatigue, frequent headaches and not being able to shake off a cold, as well as behavioural signs such as crying or angering easily, paranoia and drug abuse.
While healthcare workers remain a focus of burnout research today (understandable, especially in the context of a pandemic and the unique stresses this inflicts on frontline medical staff), the concept soon expanded to be applied to different occupations – first other “helping professionals”, such as teachers, police officers and social workers, and then other jobs too.
In an attempt to pin it down more distinctly, various groups have come up with tools to measure burnout, the most prominent being the Maslach Burnout Inventory, a questionnaire first developed in the early 1980s by social psychologists Christina Maslach and Susan Jackson. This assessment focuses on three proposed dimensions of burnout which are echoed in the WHO description. The first is a lack of energy. Michael Leiter, a professor of psychology at Acadia University in Nova Scotia, Canada, who has worked with Maslach on burnout for several decades, describes this as more than just tiredness. It’s the difference, he says, between feeling tired at the end of the work day and feeling tired before you’ve even started. Your batteries are flat. “Being exhausted before your day even begins means that you’re not managing the pattern, you’re not recovering your energy,” he says.
The second dimension of burnout reflected in the Maslach Burnout Inventory is a sense of mental distance from one’s job – a feeling of detachment or cynicism. You used to like your job, but now you don’t. The third dimension is a reduced sense of efficacy or productivity. Burnout, Leiter says, is when all three of these things occur together. He views it like the breakdown of a relationship, where the relationship is between an individual and their work. “It’s just not matching up, it’s not aligning very well,” he says. “People are looking for something different out of their work than the work is giving them, or work is looking for something out of people that’s different from what people are giving it.”
Over the past year-and-a-half, that relationship has been put under strain. It’s hard to know if burnout has actually increased as a result of the pandemic; there has not been much research into this yet, and it is in any case difficult to compare data from studies that may use different measurements or approaches. Nevertheless, researchers have sounded the alarm, especially when it comes to healthcare workers. The impact of the pandemic will have caused many people to experience an increased workload, a lack of support and resources, and uncertainty about their role – all factors that can contribute to burnout. “And then the rest of the world’s disrupted, so you can’t really go out and have fun like you used to, so you can’t really recover from work,” Leiter says.
Stela Salminen, a psychologist at the University of Jyväskylä, Finland, suggests that the pressures of the pandemic may not have created more burnout but may have exacerbated issues that already existed. “My educated guess would be that probably there were problems with the organisation prior to the pandemic,” she says.
Some gripe about the vagueness of burnout as a concept – if everyone’s burned out, then is anyone burned out? – but Voigt says that, as a social scientist, he doesn’t necessarily see this as a problem. The burnout experienced by healthcare workers thrown into the midst of a pandemic may not be quite the same as that felt by the Zoom-fatigued office worker, but many people clearly find the term useful as a way to express their feelings about their work situation. “It helps us to think through certain issues in society and it may open up space for conversations that we previously did not have,” he says.
PERHAPS NOW IS the time to blow the definition of burnout wide open. Our conversations around burnout often retain a certain element of mystique. It tends to be associated with people who identify strongly with their occupation, take a lot of pride in their work, and are, when not burned out, very motivated. “It has this notion of, you can only be burned out if you initially burned for what you were doing,” Voigt says. Some may even see burnout as a badge of honour. In certain professions, says Rajvinder Samra, a psychologist and senior lecturer at the Open University, “working yourself to the point of burnout is almost like professional socialisation.”
But though they may not regularly appear in studies, Salminen says that her research suggests that people in lower-paid jobs are in fact at particular risk of burnout, precisely because they are given less resources and less support. A hospital may invest more in helping doctors and nurses, not secretaries and cleaners.
And while most research focuses on more traditional work patterns, Leiter suggests that gig economy workers may be susceptible to markers of burnout. Being required to work odd hours, with lots of uncertainty, financial or job insecurity, and a confused relationship with the company you work for could all help to breed fatigue and cynicism. “It’s a not very fulfilling way of going about work,” he says.
Could even unemployed people become burned out? If there’s one defining point of burnout, it’s that it has to be related to work. It is an occupational phenomenon, after all. The WHO states that burnout “refers specifically to phenomena in the occupational context and should not be applied to describe experiences in other areas of life.”
But for many, the prospect of not having a job may be more stressful than having one, even if you’re not feeling fully fulfilled by it. It would be tough to research burnout in unemployed populations, Leiter says, partly because it can be difficult to access this cohort, but also because measurements of burnout have been specifically designed for work. One way to think about it could be to consider the work of having to look for a job. “One of the hardest jobs that you can do is to find a job.”
Nilufar Ahmed, a psychotherapist and lecturer in social sciences at the University of Bristol, suggests that people out of work or furloughed during the pandemic may be feeling a “slow burnout” as a result of the uncertainty around their employment and the lack of work-related fulfilment. “If I’ve been furloughed for the last eight months, where’s [my] sense of accomplishment coming from?” she says.
There’s an argument that burnout may not even be restricted just to paid work. If the pandemic has shown us anything, it’s that the line between our professional and personal lives can quickly blur. Ahmed points out that the effects of work stress don’t stay sequestered in the workplace. “The energy that’s taken to be able to maintain that and to deliver that has to come from somewhere,” she says. “And more often than not, it comes from our personal lives.”
Samra believes we should explore burnout beyond paid work, taking into account other tasks and unpaid work such as childcare and household management. “Your body doesn’t identify whether your chronic work stress is related to your occupation,” she says. What’s to say that the sense of a lack of accomplishment associated with work-related burnout couldn’t also apply to feeling like an inadequate parent, or a bad partner? “I think that people are seeing it apply regardless of work circumstances now,” Samra says. “And that’s an interesting and worrying phenomenon.”
These external stressors may not apply equally. Research on burnout among doctors has found that women are more likely to be affected than men. While this could partly be down to gendered differences in how burnout presents, Kim Templeton, an orthopedic surgeon at the University of Kansas Medical Center and a past president of the American Medical Women’s Association, says that disproportionate responsibilities in the home can play a role. Women still take on the majority of childcare and other caregiving roles, and still face gendered expectations outside of work. “Women do have societal gendered expectations, and we’re expected to do more work at home, and eventually there is this time crunch,” she says. The pandemic has amplified this conflict, further blending work and home commitments and exacerbating existing social inequalities.
OUR CURRENT BURNOUT moment may pose an opportunity to rethink our roles at work. But to truly address the societal issues that may be feeding into it, we need also to reconsider the role of work in our lives, and the many other factors that forge inequalities in the workplace and beyond.
While there are burnout interventions that might help on an individual level – taking a holiday, forming healthy habits – research suggests that burnout is best addressed on an organisational or systemic level, by making changes to the work environment. Taking a break might solve the issue short-term for one person, but if they end up back in the same environment that led to them burning out in the first place, they may continue to suffer – and it’s likely others will too. Addressing burnout in a systemic way could mean reducing workloads, redistributing resources, or rethinking workplace hierarchies. One suggestion, says Leiter, is to give people more autonomy and agency in their roles so that they can play to their individual strengths – fitting the job around the person rather than making a person fit into the job
But it could also mean grappling with broader inequalities, in the workplace and beyond. This could mean improving a toxic company culture, adapting parental leave and childcare policies, or introducing more flexible working. It could be offering more social support to parents and carers. It could mean making sure everyone has decent working rights and a living wage.
Making systems-level changes is difficult. But the return to work after Covid-19 represents a rare opportunity to do so; to shape a “new normal”. If we grasp the opportunity, then our burnout moment perhaps couldn’t have come at a better time.
All Rights Reserved for Victoria Turk