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Dorchester Center, MA 02124
These days, my news feed seems to be exploding with mentions of the word Burnout. You might be surprised to learn, however, that mental health diagnostic manuals have only recently begun to include burnout as an official diagnosis1. Recently, I completed a deep-dive into what research tells us about how we can recover from burnout. In this article, I share what I learned:
In this article, you’ll find:
The DSM-5, which is used by therapist, doctors, and psychologists in the United States, doesn’t include burnout as an available diagnosis.
However, the manual used internationally, the International Classification of Diseases (ICD-11), describes burnout as “a condition that is thought to be caused by long-term stress at work that hasn’t been effectively managed”2.
are three of the main things that inform a diagnosis of burnout, according to the World Health Organization2.
Because the ICD-11 classifies burnout as an “occupational phenomenon,” it is not considered a medical or mental health condition2, though pending research is likely to prompt a change to this within a decade.
One sneaky symptom of burnout is that we slowly come to believe we aren’t good at our job, and that our work doesn’t matter- when, in fact, often the opposite is true.
The classic symptoms of burnout include exhaustion, cognitive symptoms, loss of empathy, withdrawal and insularity, impaired work performance, and unsettled mood ((Parker, G., Tavella, G., & Eyers, K. (2021). Burnout: A guide to identifying burnout and pathways to recovery. Crows Nest, NSW.)). Many symptoms defining burnout, especially “lack of pleasure in life, inability to feel, and a drop in work performance,”3 may be particularly distressing and disruptive to income for working artists, authors, and content creators.
In the past, terms like “exhaustion” or “nervous breakdown” may have been used to describe burnout. While Burnout is a relatively new term – it was added to the ICD in 2019- it’s likely that humans have been affected throughout history.
For example, the authors of the book Burnout: A Guide to Identifying Burnout and Ways to Get Back on Our Feet look into whether Florence Nightingale, a well-known nurse, might have experienced burnout3. Burnout can happen for all kinds of people in all kinds of cultures1.
In my first position as a mental health therapist at a clinic in South Seattle, I remember one day excitedly sharing with my supervisor what I’d learned from reading Alexandra Michel’s article Burnout and the Brain: burnout isn’t about the tasks we have to manage, but the support we have to manage them4.
Instead of being excited to glean this research-based data that could help prevent burnout, my supervisor angrily insisted that therapist burnout was due to weak character or a failure on the part of therapists.
Needless today, I bid adieu to this workplace not long after, but the experience was a visceral reminder of what many of my clients who are burned out experience: blame.
Depth psychology is a branch of psychology that focuses on the deeper levels of the human psyche, including the unconscious mind. It is concerned with understanding the hidden factors that influence our behavior, thoughts, and emotions.
Given that the treatments most commonly used to treat burnout don’t seem to actually work that well 6 I think depth psychology offers valuable insight into burnout and burnout recovery.
Existential approaches to psychotherapy look at how meaning, death, and purpose work together to form a life well-lived. According to Pines7 many people choose certain jobs because they expect that job to make their life meaningful. When, a few years or a few decades into a career, it becomes clear that work cannot provide the existential significance, burnout results.
In the past, people were more likely to choose jobs based on location, pay, or family ties. Workers today, however, are encouraged to “pursue their dreams” and seek jobs that are meaningful. Many career coaching models that emphasize the value of meaning-based work and pursuing passion89 may increase the chances of experiencing burnout.
However, people who DO find their work meaningful and satisfying are more likely to avoid burnout, even if the work is intense10. A study done by Thomson and Jaques11 found that “[health] practitioners who get a lot of satisfaction from their work are less likely to get burnt out.”
Jobs that don’t live up to our expectation of giving our life meaning can lead people to feel disappointed and burned out. Pines, 2002, says this: “Treatment of burnout from an existential perspective focuses on helping individuals locate existential significance through more varied areas of life”7.
Psychodynamic psychology is another type of depth psychology. Psychodynamic approaches seek to heal through developing awareness and insight into unconscious drives and social-emotional patterns.
“People tend to choose an occupation that enables them to replicate significant childhood experiences, gratify needs that were not gratified in their childhood, and actualize occupational dreams and professional expectations passed on to them by their familial heritage”7.
In other words, according to psychodynamic psychology, burnout occurs when the work of our adult life fails to heal the wounds of our childhood or meet the expectations we unconsciously adopted from our family of origin while growing up.
From a psychodynamic perspective, burnout may be more than just an existential problem of work not giving life meaning, but frustration (perhaps even despair) as the subconscious mind realizes that the chosen work cannot, after all, heal the wounds left by childhood.
Much of the literature on treating burnout centers on interventions like helping individuals learn to seek support, set boundaries on emotional investment and time, cultivate mindfulness, and seek restorative rest12 while other sources insist that recovery from burnout requires a shift within organizations510 or even entire cultures to change13.
The problem with all that? Well, none of these strategies seem to work particularly well.14 Creating a family budget, taking time off work for vacation, setting boundaries with challenging people, and other surface-level actions can help but may not create meaningful change.
Whether you seek treatment for burnout or are learning to manage your own experience of burnout, meaning-based approaches can be helpful.
If you’re a faithful reader, you know I love making genograms. Genograms, which allow us to see visual representations of the systems we are part of, can be helpful in developing insight into how current workplaces echo dysfunction in our early life- echos that can be at the root of burnout.
Complete a genogram focused on the occupations, personality, and interpersonal relationships of the people in your family tree7. For which family members was work more important than family? Who chose meaningful jobs over high paying jobs? What is or was the family culture around work
Using supervisor-manager-entry level hierarchies as generations, create a genogram of the individuals who are above and below you in rank at your workplace. What are their values around work, rest, meaning, and support?
Take these genograms with you to therapy for additional insight into how patterns from family, personal life, or childhood might be repeating in professional life. Understanding early life experiences and generational norms can help people who are suffering from burnout understand how their career choices and expectations for meaning from their work might be linked with symptoms of burnout7.
“Burnout is a process in which highly motivated and committed individuals lose their spirit”7. People today may be more likely to expect personal fulfillment from work because today’s culture places a high value on careers based on interests and passions.