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Burnout Syndrome

Burnout Syndrome

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Introduction

Nowadays, the burnout syndrome negatively affects many societies and individuals and it becomes a serious problem. Therefore, the term ‘burnout’ and ‘burnout syndrome’ should be understood well and finding functional solutions to solve the matter is critical. Especially in this age where human beings can find whatever they want to satisfy themselves, physically or economically; however they cannot satisfy themselves spiritually or psychologically. They have the best, the latest or the most beautiful things but are still insatiable and unhappy. To satisfy their needs and individual benefits, people ‘go all they way’ and become tired. However there is no end to these wishes, because it is no more than drinking the water of the ocean, it will only worsen a person’s thirst.

We see many managers, workers, housewives, teachers or doctors who love their jobs in the beginning, but with time they become estranged from their very jobs, activities or responsibilities. In the end, they experience physical, cognitive and psychological burnout. The state of burnout does not exist instantly; it takes time and develops slowly. However, when it starts to negatively effect people, they might start to be unproductive, leave their jobs, fall hopeless and in need of professional support.

What is a Burnout Syndrome?

The term ‘burnout’ which deeply affects societies and human lives was first used in 1969 by H. Bradley; and then American psychologist Herbert Freudenberger defined burnout as a state of fatigue or frustration that resulted from professional relationships that failed to produce the expected rewards.[1] However, Maslach explicitly defined burnout in 1982. According to Maslach, burnout as a psychological syndrome involving emotional exhaustion, depersonalization, and a diminished sense of personal accomplishment that occurred among various professionals who work with other people in challenging situations.[2] As it can be seen, the term of burnout is not only related to the situations of physical breakdown. It also contains the cognitive symptoms of breakdown.

There are many definitions of burnout syndrome but this article shall discuss the one that affects people’s lives negatively and destructively. Therefore to prevent burnout syndrome an understanding of the causes is needed and then the solution methods should be implemented carefully.

Causes of Burnout Syndrome

There are many individual and institutional factors that can cause the burnout syndrome.

A. Institutional Factors:

The most common cause is stress. The term ‘stress’ was first introduced in 1977 by Prof. Hans Selye. Selye defined stress as “the non-specific response of the body to any demand for change”.[3] Stress has many negative effects upon people and expedites the burnout syndrome’s existence and development. Doctors, health workers and experts in particular who need to be in contact with many people are at risk of suffering from burnout. Therefore this syndrome might negatively affect a person’s stress level, unsuccessful coping strategies, state of psychology and work performances.

  • Excess workload or lack of workload can cause burnout syndrome.

  • Having an unsatisfied job, working only for financial gain or a wrong career choice can also cause burnout.

  • Doing the same job for a long time and in the same position can cause burnout and decrease the amount of pleasure of working with time.

  • Late or early promotion is an institutional factor, which can cause the burnout syndrome.

  • Unhealthy working environment can cause stress and burnout. One research shows that too hot or cold environment, heat and humidity problems, insufficient or excessive lighting, dirty air and dust, toxic substance and radiation, occupational accidents are the factors that can stresses out the employee.[4]

  • Overtimes, lack of breaks, shift-working system can tire employees and break their biological balance in time. A research found that, the ideal working time is 7,5 hours a day, 45 hours a week.[5] When these times are exceeded, employees can experience serious physical and mental problems.

  • Dominant, unjust and unsympathetic employer or authoritative and maladaptive colleagues can drain the energy of an individual.

  • Unprofessional work environment, unclear of working conditions, unclear roles of job, or noninstitutional job can make employees feel they are forced to work hence decrease the quality of work.

  • Being non-effective and having lack of rights of initiative can cause a decrease of self-esteem and produce pasive worker in time.

  • Unjust or low payment can decrease work’s effectivity and quality; while at the same time employees can quickly feel demoralized. Payment is the reason to put up with all the intensive conditions of a job, so if the payment is not enough or unsatisfying, workers can feel burnout easily.

  • Another institutional factor is mobbing. Mobbing refers to ‘bullying at work’ and nowadays, many employees are exposed to mobbing. According to statistics, victims come from different occupational groups. A research conducted in the health sector shows that last year’s mobbing prevalance is 50,9% in Taiwan and 76% in Bosnia. In Turkey, a research conducted with nurses shows that, the rate of mobbing is 86,5% in last year alone. As a result of mobbing, many individuals can experience emotional and physical violence and leave their job. This situation can cause burnout, depression and anxiety disorder.[6]

  • Lack of consultant, control, security, occupational health personnel, limited opportunity and substructure can cause burnout syndrome in institutions.

B. Individual Factors:

  • Character (Type A personality)

  • The need of approval all the time

  • Low self-esteem and low self-respect

  • Physical, mental, and emotional exhaustion

  • Excessive expectations and perfectionism

  • Excessive control and workaholism

  • Low motivation, low productivity

  • Self compromise

  • Inability to say no

  • Inability to have limits

  • Impatience and hasty personality

  • Age, gender

  • Marital Status

  • Number of children

  • Educational Status

  • Conflicts in the family

  • Cultural gap, adaptation problems

  • Irresponsibility

  • Psychological disorders, physical disorders

  • Alcohol and substance abuse

  • Lack of social support and social relationship

Employees who have these symptoms generally think that they are not good enough and successful in their jobs and they tend to distant themselves from their jobs and become passive and unsatisfied. These processes are the expected stages of a burnout syndrome and shall be discussed in detail below.

The Stages of Burnout

There are three main dimensions of burnout according to Maslach and Jackson:

  1. Emotional Burnout

  2. Desensitization

  3. Lack of Personal Success[7]

  1. Emotional Burnout

Individuals have the tendency to be idealistic, willing, decisive, fearless, determined and ready to work hard in difficult situations in the beginning of their work life. They spend their energy to solve problems, create new things and work very hard. Thanks to this high energy they are not aware of tiredness. This period can be called the honeymoon phase. However later on they start to feel exhaustion and their energy decrease over time. The problem can disturb their job and this is when they start to feel the first emotional burnout stage in their inner world. An employee is consumed in terms of their emotional resources and power, causing them to experience the loss of energy, motivation and inability to show their previous performance.

  1. Desensitization

When internal and external factors that lead to emotional burnout continue, the second stage of burnout, which is called desensitization would begin. Employees can no more be polite, easygoing and interested with their job; they will instead become rude, pessimistic and rigid about their job and turn against their colleagues. At the same time in this stage, stress begins to show. Employees are exempt from their emotions and start to be more behavioral and realistic, depreciatory, facetious and uncompanionable.[8] The desensitization stage refers to the interpersonal dimension of burnout rather than being internal.[9]

  1. Lack of Personal Success

The last stage involves the lack of personal success, negative ideas and negative self-judgement. Employees would start to develop the tendency to think that they are useless, unsuccessful, ineffectual in their job and not productive. Therefore they experience more dissatisfaction. At the same time, their stress and exhaustions develops to be chronic. These situation can lead them to work less, busy with something outside of their job, decreased performance, come to job late, miss deadlines, behave irresponsibly and work only for money.Also, job switching, resignation, physical and psychological illness, alcohol or drug consumption, social withdrawal from family and friends might also be seen.

After these symptoms, those employees would develop burnout and if it continues, it would turn into a chronic burnout. Psychologists Herbert Freudenberger and Gail North explain that the burnout syndrome does not develop in one day. It improves and develops in 12 stages. These stages do not need to occur in order; in other words, a person might experience more than one stage at the same time.[10] Below are the stages that psychologists outline:

  1. The Compulsion to Prove Oneself

  2. Working Harder

  3. Neglecting Needs

  4. Displacement of Conflicts

  5. Revision of Values

  6. Denial of Emerging Problems

  7. Withdrawal

  8. Odd Behavioral Changes

  9. Depersonalization

  10. Inner Emptiness

  11. Depression

  12. Burnout Syndrome

The Symptoms of Burnout Syndrome

It is possible to take the symptoms of burnout syndrome under behavioral, psychologial, physical, cognitive and social areas. The following table depicts the symptoms in detail and a person might develop more than one symptom over time.

  1. Behavioral Symptoms

  • Excessive smoking

  • Increase in the use of alcohol

  • Substance abuse

  • High-risk behaviors

  • Violence

  • Excessive eating

  • Hyperactivity

  • Sleeping problems

  • Excessive working

  • Unwillingness to go to work

  • Go to work late or leave from work early

  • Being close to critisicm

  • Decrease of interest against work

  • Being fatigue, agressive behaviors
     

  1. Psychological Symptoms

  • Anxiety

  • Stress and panic

  • Depression

  • Feeling overloaded

  • Fear and paranoia

  • Feeling out of control

  • Feeling guilty and worthless

  • Hopelessness, desperation

  • Tension and anger

  • Feeling nervous, under pressure

  • Questioning themselves and their job

  • Feeling empty, aimless and alone
     

  1. Physical Symptoms

  • Feeling tired constantly

  • Loss of energy

  • Becoming sick more frequently

  • Headache, stomachache and nausea

  • Muscular pains and cramps

  • Digestion problems

  • Pain in the back and waist

  • Nightmares

  • Shortness of breath
     

  1. Cognitive Symptoms

  • Concentration and attention problems

  • Inability in making decisions

  • Thought disorder

  • Avoidance from specific ideas

  • Dreaming often

  1. Social Symptoms
     

  • Weariness

  • Being far away from friends

  • Marriage and family problems

  • Restriction from social relations

  • Criticizing themselves and others

  • Conflicts between couples

  • Excessive dependency to others

Protective Factors for Burnout Syndrome and Solution Techniques

Preventing burnout syndrome in employees who work at different sectors is an important and necessary matter. When addressing a burnout syndrome, applying both individual solution techniques and institutional solution techniques are required.

1. Individual Solution Techniques

  • First of all, having a good job (from an individual perspective) and getting the pleasure from this job is a very important protective factor from burnout. At the same time, being aware of job’s responsibilities, limits and conditions are also necessary.

  • Then, if an employee has any disability or special situation, the managers and colleagues should know about this. This is done so that any possible difficulties can be prevented. Also, if other employees are aware about these difficulties, they should put more effort to address the problems that might occur.

  • Organize a work group, take the support from supervisor, when necessary shift to another department to refresh a potential burnout employee.

  • Use the time-off effectively during break time, or have vacations to relax.

  • Individuals should take some time to themselves daily and this time should be thirty minutes the least. During this time it as adviced for the individuals to rest, practice breathing exercises, relaxing exercises, move away from stressful things as coping techniques from burnout syndrome.

  • Regular exercise, sports, balanced nutrition and quality sleep are so important and can help individuals to cope with stress and burnout.

  • Hobbies and artistic activities can help individuals to feel better and relaxed.

  • Having social environments and life outside work also help individuals to rest when working under intensive tempo of work.

  • Family problems affect individuals negatively, therefore solving these conflicts and spending time together are helpful techniques to prevent burnout.

  • If there is a psychologist or counseler in an institution, sharing problems and seeking solutions with them can be helpfull.

  • Turning to alcohol or harmful substances when facing problems are not a solution, on the contrary they complicate the problems even more.

  • Time management should be well organized. ‘Me time’ and work time should not be mixed with each other.

  • Long-term tasks should be well-planned and broken up into segments. When an employee feels some difficulties, they should ask for help from a friend or advisor. These are relaxative techniques. Therefore, determining some aims and taking firm steps forward even in a long time is required.[11]

  • Do not mix professional work and voluntarism.

  • When deemed necessary an individual should say NO and avoid from self-compromise.

  • An individual should express their ideas and the emotions that disturb their feelings. Otherwise, repression can develop and that individual may suppose that repression might just solve the problem. But the fact is that repression can solve the problems only in a short term, in a long term it makes the problem even bigger than before.

  • Being a constant superviser or perfectionist may drain an individual. People make mistakes and this should be understood.

  • The perception of success, responsibility, acceptence, appreciation and self-respect should not be excessive. Any individual should be flexible and moderate.

  • Empathetique and considerate work environment are protective factors from burnout.

  • Learning about the burnout syndrome and its coping techniques can be helpfull.

  • If necessary, taking professional care and support can help solve problems and prevent burnout. Do not hesitate. Psychotherapy may support individuals and help them to be more positive and calm. However burnout progresses slowly but it becomes the cause of depression, anxiety and other psychological disorders in time. Therefore, taking psychological support or if necessery going to a psychiatrist is a very important technique to address burnout syndrome.

2. Institutional Solution Techniques

  • If working time is long, change it to the ideal time.
  • If there is a problem with work, it should be modified, reorganized and working conditions should be improved.
  • Giving employees the right to take an initiative, making a plan and organization for the work of the employees and supporting them by giving them some authorities is of important institutional techniques.[12]
  • If the number of employee in an instituion is not enough, recruitments may be helpful instead of overworking the existing employees.
  • The limits of tasks and responsibilities, expectations from employess should be strictly defined in the beginning of their employment.
  • Control and supervision mechanisim should be implemented.
  • Not making a career plan can cause burnout. Therefore, a good career plan is necessary for job satisfaction.[13]
  • Educational program and activities such as supervision, consultation and coaching should be organized and all employees should be supported with training and education.
  • Departmant meeting, general meeting and meeting to take feedback from employees should be organized regularly.
  • Distribution of payment should be fair. Premiums, bonuses and prizes which are motivation channels for employees should be distributed fairly where it and satisfies them.
  • Institutions can motivate the employees by organizing vacations and social activities.
  • The absences of security as well as work place problems should be solved to enable employees to work healthily and effectively.
  • If certain problems linger after the implementing all the steps, then an employee can change to other unit or even change their job by themselves.
  • Rotating hard jobs or distributing responsibilities to employees in a fair way can prevent work overload to one specific worker and helps to prevent burnout.[14]
  • The communication between employees and their employer should be respectful and based on productivity. An employer should take into account the employees’ ideas and the employees should also be able to participate in the decision-making process.
  • Shift working system should be modified, as few shift as possible should be put repeatedly and morning shifts should not start too early. Lastly, service vehicles should be provided for employees for going in and out of work.
  • Institutions should not give redundant jobs to employees and they should respect their rights to have vacations and other permissable leaves.
  • In some period, employees and their employer should come together to talk about their job, problems and solution techniques.

Summary

It is clear that burnout syndrome does not develop in one day. It takes time to emerged. All the repressed or accumulated problems, negativities in job/life become the cause of burnout syndrome to grow. After the burnout syndrome emerged, it effects work performance and social relationship of employees negativly and destructively. Therefore when addressing the burnout syndrome, mere individual techniques are not enough. At the same time institutional efforts and helps are playing important roles. If these innovative activities and solution techniques continue in parallel, burnout individuals can be treated and institutions can minimize burnout upon employees. Otherwise, if one party puts its effort and the other party becomes avoidant in the end productivity will plunge and the burnout syndrome will grow and spread. Worst-case scenario, employees might resign and employers will lose their workers. This situation can also badly contribute to the country’s economy.

It should be noted that, if the motivation of individuals increase then their performance would increase too. In the opposite situation, individuals will not give any benefit to themselves, the institutions they work at, and their countries.[15] Furthermore, individuals may have to deal with other physical, psychological, social and economic problems. Therefore all individuals and institutions should be informed about the burnout syndrome and its contributing factors.

Finally, when the slightest sign of this syndrome is seen, the necessary corrective steps should be taken immediately. After all these corrective and problem solution methods, if the problem continues then taking professional help is vital and those suffering from this syndrome should not hesitate to seek professional help.


[3] ‘‘What is Stress?’’, The American Institute of Stress, https://www.stress.org/what-is-stress

[4] Alptekin Sökmen, “Konaklama İşletmeleri Yöneticilerinin Stres Nedenlerinin Belirlenmesinde Cinsiyet Faktörü: Adana’da Ampirik Bir Araştırma,http://www.acarindex.com/dosyalar/makale/acarindex1423878702.pdf

[5] Mehmet Zülfi Camkurt, “İşyeri Çalışma Sistemi ve İşyeri Fiziksel Faktörlerinin İş Kazaları Üzerindeki Etkisi”,  http://tuhis.org.tr/dergi/cilt20_21sayi6-1/cilt20_21_sayi6-1_bolum5.pdf 

[6] “Yıldırma (Mobbing)”, Türkiye Psikiyatri Derneği, http:// www.psikiyatri.org.tr/halka-yonelik/15/yildirma-mobbing

[7] “Guidelines for the primary prevention of mental, neurological and psychosocial disorders”, World Health Organization Division of Mental Health, https://apps.who.int/iris/bitstream/handle/10665/60992/WHO_%20MNH_MND_94.21.pdf?sequence=1&isAllowed=y

[8] Güler Sağlam Arı, Emine Çına Bal, “Tükenmişlik Kavramı: Birey ve Örgütler Açısından Önemi”, https://dergipark.org.tr/tr/download/article-file/145983

[9] Gülay Budak, Olca Sürgevil, “Tükenmişlik ve Tükenmişliği Etkileyen Örgütsel Faktörlerin Analizine İlişkin Akademik Personel Üzerinde Bir Uygulama”, http://dergipark.gov.tr/download/article-file/211280

[11] Kamil Ertekin, “Tükenmişlik Sendromu Ve Önlenmesi”, https://www.e-psikiyatri.com/TUKENMISLIKSENDROMU-VE-ONLENMESI-440

[12] Öznur Yüksel, İnsan Kaynakları Yönetimi, Ankara, Gazi Kitapevi Yayınları, 2007, s. 86.

[13] Tuğray Kaynak, İnsan Kaynakları Planlaması, İstanbul: Alfa Yayınları, 1996, s. 161.

[14] Dr. Füsun Ersoy, Dr. R. Cenap Yıldırım, Dr. Tamer Edirne, Tükenmişlik (Staff Burnout) Sendromu”, http://www.ttb.org.tr/STED/sted0201/1.html

[15] Ali Akdemir, İşletmeciliğin Temel Bilgileri, Çanakkale, ÇOMÜ Yayınları, 2004, s. 77-78.