Burnout

The expression Burnout appeared in sports jargon in the 1930s to indicate the inability of an athlete, after repeated successes, to obtain further positive results and/or to maintain the acquired ones.

It has first been introduced in the field of helping professionals with psychologist Herbert Freudenberger’s 1974 study but it was only in 1975 that the American psychiatrist Christine Maslach during a conference, used this term to define “a syndrome characterized by emotional exhaustion, depersonalization and reduction of personal abilities”, thus identifying burnout with a specific occupational disease. Since then, burnout has been dealt with especially with reference to “helping professionals” in the socio-psycho-health field: doctors, nurses, caregivers, psychologists and all those people who deal with assistance or who are in daily contact with suffering.

After decades of studies, the WHO (World Health Organization) has recognized work-related stress as a syndrome and provided guidelines for diagnosis. With the inclusion of burnout in the large list of medical disorders, updated from year to year, this type of disorder has been categorized as a “problem associated with the profession”. Symptoms such as “exhaustion in the workplace”, “cynicism, isolation or in general negative feelings” and “reduced professional efficacy” clearly emphasize the consequences that this disorder has on the person and the patients.

The onset of the syndrome generally follows four phases:

1. The first phase (idealistic enthusiasm) is characterized by the reasons that led the operators to choose a type of care work; these motivations are often accompanied by expectations of “omnipotence”, of simple solutions, of generalized and immediate success. Workers face difficulty in reading the “reality” of the care situation and might believe that the coming to terms with a difficult case does not depend on the very nature of the situation itself, but essentially on one’s own abilities and own efforts. Therefore, if the problem is not solved, it means that you have not been up to it.
2. In the second phase (stagnation) the operator continues to work but realizes that the work does not fully satisfy his needs. In this way we pass from an initial super investment to a gradual disengagement where the feeling of profound disappointment causes a closure towards one’s work environment and colleagues.
3. The third phase (frustration) is the most critical of burnout. The dominant thought of the operator is that he/she is no longer able to help anyone, with a profound sense of uselessness and non-compliance of the service with the real needs of the user. The subject can assume aggressive attitudes and often puts into practice escape behavior such as leaving the ward without justification, taking prolonged breaks or frequent absence due to illness.
4. In the fourth phase we witness the gradual transition from empathy to apathy; during this phase there is a real professional death.

It should be kept in mind that burn-out differs from stress, which can possibly be a contributing factor to from various forms of neurosis, as it isn’t a disorder of the personality but a disease associated to the work role. Furthermore, it must be stressed that burn-out is not at all a personal problem that concerns only those who are affected, but it is a contagious “disease” that spreads from users to the team, from a team member to a team member and from the team to the users.  Therefore, it concerns the entire organization.