It’s time to confront burn out. Over 50 percent of behavioral health providers report experiencing symptoms of burnout in a 2020 study.

| 7 minute read |

Is burnout in healthcare workers prevalent post-COVID19?

Short answer: Yes. As if excessive red tape, diminished funding and dealing with insurance companies wasn’t enough—healthcare professionals rank high in burnout statistics. 

Yet,  burnout isn’t reserved for only the behavioral health workforce. Dr. Rachel Naomi Remen reflected on her years in the medical field and shared wisdom in her book, Kitchen Table Wisdom:

What a beautiful mess. And we choose to work in these fields! I appreciate Dr. Remen’s words. However, I’ve never fully connected the grief experience with burnout. But it makes total sense–especially if we lose a client or patient to death, suicide or when they endure other horrible circumstances. We are closely associated with our clients’ experiences and feelings. We walk together for a time. Side by side.  For myself, I prefer the term catharsis rather than grief. Those who know me best, also know I seem to absorb and bottle up everyone else’s emotions, stressors and trauma. Their chaos eventually induces anxiety, depression, or rage within me–even when I mindfully practice safe boundaries. I need healthy coping and cathartic activities to help my mind, body, and soul express the inexpressible. This kind of work takes a toll on us.

As Dr. Remen says, in a sense, we have lost hope when we care so deeply for others and do not fully grieve (or as I prefer, experience habitual catharsis). “Love is the only way to rescue humanity from all ills.” Leo Tolstoy wrote this in his letter-correspondence with Mahatma Gandhi during the rise of India’s independence from British colonial rule. And I have to agree with the general idea. We are human. To validate and empathize another’s suffering is an expression of love. To be fully human, is to love fully. Loving fully heals all wounds.

As beautiful as it all sounds, empathetic humanity contributes to burnout and burnout can subtract humanity from us. We begin to numb, distance ourselves, or minimize others’ pain and suffering instead of bearing their burdens alongside them–just as Dr. Remen explained previously. So what does this mean for healthcare professionals throughout the duration of their career?

It appears burnout may be the dilemma of this era for those helping fields. Consider nurses, doctors, and educators. Counselors, therapists, and social workers join the ranks among rescue workers and law enforcement (even pastors) in this phenomenon of burnout. So this an important matter as it pertains to the sustainability of physical, mental, social, and spiritual health. As widespread as burnout is, when did burnout become a thing?

Many claim the COVID-19 pandemic established this phenomenon. But you and I know better. The pandemic only aggravated this pre-existing issue among workers in healthcare. 

Although not exactly synonymous—compassion fatigue, depression, trauma, secondary trauma and PTSD (Post-Traumatic Stress Disorder) all seem to intersect. With similar causes and symptoms as burnout, these conditions are both relatable and related.  

Let’s clarify a few things. In 2013, the American Psychiatric Association defined trauma as “actual or threatened death, serious injury, or sexual violence” (p.271)--a definition that continues to be under scrutiny (Pai, Suris, North, 2017).  Whereas, PTSD is defined as a mental health condition that may occur as a result of witnessing or experiencing a traumatic event (PsychCentral, 2021). (As a brief aside, not everyone who experiences trauma will have PTSD.)

But what about healthcare workers who work with individuals who have been traumatized? Research says workers who serve survivors of trauma are more likely to experience compassion fatigue. 

Compassion fatigue can be described as, “stress resulting from exposure to a traumatized individual,”  (Cocker, Joss, 2016) and secondary trauma or secondary traumatic stress (STS) can easily lead to burnout (BO). Some experts argue it’s the other way around. 

If research shows a conditional link between PTSD symptoms and trauma exposure (Pai, Suris, North, 2017), then those servicing traumatized clients may experience secondary trauma, as well. I think all mental health clinicians can agree our clients alter us when they disclose the intimate details of traumatic events.

What’s the glaring fact in all of this? Burnout. Because our exposure to traumatized clients links to compassion fatigue, burnout is the total sum of all work-related stress, to say the least. It’s simple psychophysiological math.

Trauma + Depression + Anxiety = PTSD

Or is it…

Trauma + Secondary traumatic stress  = Burnout = Compassion Fatigue

No matter how you divide it, it’s obvious these terms and conditions are relatable and related. It’s an interconnected phenomenon that goes round and round. Is anyone else feeling dizzy? 

Cocker and Joss summarized it best, saying:

So what are we doing to address the deteriorating health of healthcare workers? If you fear you may be at risk of burnout from work-related pressures and personal stress, then take this brief 10 Question Quiz. Or better yet, sign up here to receive updates on our upcoming bundle, packaged with TONS of helpful information and tools to help you combat burnout in helping professions. It’s time to take your life back.

If you had all the answers, you wouldn’t be here reading this, would you? (Nope.) And what you’ve tried hasn’t worked? (Nope.) Join the club. (Try this, instead!) So, are you willing to make changes? Are you prepared to achieve success in both your personal and professional life? Not everyone will understand your newfound hope and peace. (“That’s okay. I’ll finish that project tomorrow. I need rest.”) Not everyone will support you. Are you prepared to confront any push-back or disparaging comments about your work ethic? Perhaps you’ll be a rebel against the status quo. Or maybe be misunderstood as a modern-day martyr. Yet you know the truth: you will no longer allow your job or anything else to steal your health, rest, time with loved ones, or sanity.

If you are in any of these helping professions, do you feel the effects of burnout? Have you noticed colleagues or loved ones suffering through compassion fatigue? What about secondary traumatic stress? What will you do? Seize the day! Your health and the health of others, depends on it.  

In our ongoing series, we’re going to continue this conversation of self-care and self-compassion within careers riddled with burnout and in a culture tormented by the ideal of productivity. Why wait to change? Do you believe anyone else can decide for you? (Nope.)

It’s time for a shift. Transformation. I know I need a win. It’s time to counter burnout and poor self-care. Take a step. For you, that might mean rest. For others, advocacy. It is likely drawing boundaries and saying no to some people. It might mean using your paid time off or taking an extended weekend to get out of town. Read a book. Get to the gym. Change any unhealthy rhythms. Soon you’ll experience strength and hope to allow you to tackle the issue on the front lines—in the workplace.

If you fear you may be burnt out from work-related pressures, magnified by personal stress, then take this brief 10 Question Quiz or better yet, sign up here to receive updates on our upcoming digital bundle, packaged with TONS of helpful information and tools to help you combat burnout in helping professions. It’s time to take your life back.

References

1. Abramson, A. (2022, January 1). Burnout and stress are everywhere. https://www.apa.org.https://www.apa.org/monitor/2022/01/special-burnout-stress

2. American Psychiatric Association . Diagnostic and Statistical Manual of Mental Disorders. 5th ed. American Psychiatric Association; Arlington, VA, USA: 2013.

3. Center for Substance Abuse Treatment (US). Trauma-Informed Care in Behavioral Health Services. Rockville (MD): Substance Abuse and Mental Health Services Administration (US); 2014. (Treatment Improvement Protocol (TIP) Series, No. 57.) Exhibit 1.3-4, DSM-5 Diagnostic Criteria for PTSD. Available from: https://www.ncbi.nlm.nih.gov/books/NBK207191/box/part1_ch3.box16/

4. Figley C.R. Secondary Traumatic Stress: Self-Care Issues for Clinicians, Researchers, and Educators. The Sidran Press; Baltimore, MD, USA: 1995. Compassion fatigue: Toward a new understanding of the costs of caring; pp. 3–28.

5. Lebow, H. I. (2021, June 21). Post-traumatic stress disorder (PTSD). Psych Central.  https://psychcentral.com/ptsd/ptsd-overview

6. Pai, A., Suris, A., & North, C. (2017). Posttraumatic stress disorder in the DSM-5: Controversy, change, and conceptual considerations. Behavioral Sciences, 7(4), 7. https://doi.org/10.3390/bs7010007

7. Popova, M. (2017, October 20). Why we hurt each other: Tolstoy’s letters to Gandhi on love, violence, and the truth of the human spirit. The Marginalian. https://www.themarginalian.org/2014/08/21/leo-tolstoy-gandhi-letter-to-a-hindu/

8. World Health Organization. (2019, May 28). Burn-out an "Occupational phenomenon": International Classification of Diseases. World Health Organization. Retrieved February 25, 2023, from: https://www.who.int/news/item/28-05-2019-burn-out-an-occupational-phenomenon-international-classification-of-diseases