Sunday, March 30, 2008

Something for the boss

Mismatches
Last week I wrote that an effective treatment of burnout will always be multi-faceted, every angle should be approached. What we didn't consider then was that often there can be a serious mismatch between someone's personal style and job-expectations and the (implicit) expectations that the working environment has about the colleague/employee. If becomimg burnout has a relation with having to function in a large-scale organisation, then this also deserves attention in treatment.

6 different sources
Christina Maslach stated it quite right in het book "The truth about burnout". She describes a process as follows:
A high workload is almost always the starting point in getting burnout. Everybody is always busy and modern management, prompted by budget considerations, is always pressuring employees to do more in the same amount of hours.
This easily leads to a situation where emplyees come to think that they lost grip on their work. Next step may well be that you start to think that you are quite badly paid for all your efforts and the troubles your boss throws in with you for free. Once you are going down on this way of thinking you can easily jump to the conclusion that you are working in an extremely unfair system. Large-scale organisations are characterised by a fierce internal competition. You can easily feel all alone in a serious competition where your colleagues don't mean well with you at all. In the end you see ever more differences between what you stand for in your own work and what you perceive the organisation is targeting for.

Subjective? Objective? And what to do next?
Now the process, described as it unfolds, is of course a highly subjective one, it is all part of somebody's unique individual experience. Still, if emplyees go through such an intra-psychic process, there must be another, more objective and job-related reality behind it. A good therapist should always be alert on these phenomena and will have to find a way to exert some influence here. Usually this should be found by connecting with the human resources department of the company under consideration.

Monday, March 24, 2008

What would be an effective treatment?

A feassible approach
Now, is burnout something which is to be treated easily or not? At least a great number of approaches have been described so far. You can easily imagine that there will be a winning approach just for you. Just to name the most common: psycho-education, relaxation-training, stressmanagement, cognitive therapy, lifestyle-improvement, assertivity-training, social skills-training and selfhelp- or peergroups. Now these approaches are not all in the same line and are not readily to be compared to each other. If the original analysis is completed client and therapist together may decide which approach might be the most useful, given the particular situation. And then still: a skilled therapist will probably not want to work with just one approach, he will strive to offer a mixture to size. The most usual mix here will contain a cognitive approach (you examine together if everything you think about your situation, is realistic), there will be some attention for learning how to relax and the client's general lifestyle will be examined.

Effectivity
There is quite some research going on as to how effective all these various approaches are. Whereas burnout is such a young, but nevertheless very serious social and mental problem, we will not see the end of this research shortly. If you are a client yourself, you can easily check for yourself whether you are in good hands by looking at the chosen approach. If it is not one-sided but goes into several aspects of your problem, you can safely suppose that something good will come out of it.

Sunday, March 16, 2008

A nice exercise

The miracle question
The here following small mental exercise is a good example of how you can actively handle your burnout.
Imagine a situation as follows. You are in bed, sound asleep. That night you are visited by an angel. The next morning you wake up and all your problems have disappeared. like snow melting in the sunlight. You feel fit and well-rested, life smiles at you and you feel like going back to work. The question you have to ask yourself then is: What exactly has been changed that makes things so much better and easier? If then you do correct thinking you will find a number of things that you will be doing different or that you approach from another angle. It is recommended to repeat this exercise a number of times, most probably you won't be completely aware of everything that counts the first time ever you make this "drill".

A fine example
In my practice of course I also sometimes use such techniques. One of my clients had become quite seriously burnout. In his case it wasn't particularly his workload but rather all the things he demanded of himself. I got to know him as a highly active man who could bring up a constant stream of new ideas and who also spent much time and effort in developing these ideas. Now of course not everything ended succesfull and coming a certain time, burnout hit him. After a couple of weeks of treatment and analyzing his situation thoroughly he was able to go to work with the miracle question.
Fortunately my client very quickly brought the insight that he should handle the products of his fertile mind in a different, less impulsive way. Stopping his flow of ideas wasn't necessary, but doing a quick check with colleagues and giving yourself another day to think things over, that was certainly possible. Acting after just this particular insight became an important factor in his recoveryprocess.

Sunday, March 9, 2008

Burnout increasing

More professions affected
The last 15 years or so, we notice a shift in the prevalence of burnout. Whereas before they were the classic servicing professions that got affected, we now see in almost any major organisation that also staff with an administrative or technical job can become burnout. The question of course rises what would cause this?

The world becomes smaller, the competion enlarges
With the rise of globalization and the explosive growth of informationtechnology, we see that companies find themselves surrounded by an ever growing competition. Many companies react with classic responses: they try to lower the costs and to increase the productivity rate of each staff member. Now especially here companies can go about quite bluntly. They demand more product, more results by the single employee, without investing much in additional methods, tools or systems that can actually help to make this possible at all. Almost every employee of a major company worldwide can tell the tale that more is expected of him than 20 years ago. To cut a long story short: the pressure of work has increased dramatically all over. That ever more employees lose track and become burnout is therefore no surprise at all.

A change of quality
Next to the rising pressure, we also see that interhuman relations and processes have gained in importance on the work floor. Many companies these days use the phrase "internal" client. This means actually that there is another department waiting for your results, to deliver themselves in time. If you define the internal relations in a company like that, you should realise in advance that you place your employees in a permanent process of negotiation. From there on we come back seamlessly to the beginning of the story: it is the relationship with others, next to a high workload, being both the causing and maintaining factor in burnout. Companies and institutions should have much more attention for these phenomena than is actually given these days.

Sunday, March 2, 2008

Who is vulnerable?

Professionals & clients
Becoming burnout absolutely has a relation with having a personal contact with others. This personal contact will often involve a relationship of dependency. The "other" wants something from the "professional", whether this professional is a lawyer, a residential worker, a nurse or a social worker. The professional hears the call and goes to work to satisfy the "client". So far, so good, the laws of question & demand should do their work.

Making effort
Now the inter-human relations are not as simple as you might innocently think. Each client is different and should be treated accordingly and nobody can be neglected. And, don't forget, just the amount of effort you put in for your clients will show to yourself, to your colleagues, your client's family, the clients themselves and maybe your employer, just what an excellent ...(lawyer etc.) you are. The harder though you try under these perspectives, the bigger your emotional involvement. The client communicates a certain need or shortage and the professional responds. Whether he succeeds in answering the question or not, at the next appointment the professional will try his very best to show that he did everything possible. A vicious circle of unanswerable questions (client) and wasted energy (professional) can evolve very easily. We don't have to mention the eventual consequences for the psychic condition of the professional.

Vulnerable professions
Now this spending of mental energy and the communicative pattern behind it, of couse surfaces more in certain professions. Just to mention: nurses, residential workers, social workers, priests, lawyers, teachers and (sigh!) psychologists. Remarkably absent here are the medical doctors, in my experience they hardly ever become burnout. Their professional code forces them to always carry on and their training is apparently much better focused in evading the pitfall of a massive emotional involvement.