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Why Helpers Burnout Out So Quickly (& Deeply)

Posted on June 19, 2015

Welcome some new members from around the state of Arizona!  We had a great Medical Case Management Training last week and the weather was nearly perfect too!  Our community is approaching 500 members and I know some people read regularly that are not on our e-mail list (Hi Mom!).  Thanks for being part of this great and growing community!

Today I want to talk about us.  Recently, I have had the opportunity to do quite a few Thrive: Self-care Trainings around the country.  Besides discussing compassion fatigue, vicarious trauma and secondary trauma, Thrive spends time considering the process and impact of burnout on helpers.

It is not a secret that we have a high level of burnout in the helping professions. Historically we have labeled our condition as burnout when it was really compassion fatigue, vicarious trauma and secondary trauma. I think our work, and the nature of working with human beings, does expose us to burnout more than any other profession.  This post will explain why this happens and the importance of catching burnout in its initial phases so it does not permanently harm us physically, socially, emotionally and cognitively.

Stress is our biological reaction to changes in the environment.  This can be a source of motivation that allows us to accomplish great things in life, this is often called eustress.  Stress can also be negative and exhausting and this is the stress that leads to burnout. Bad stress, also called distress or strain, is exacerbated by three intensifiers and this is where we’ll start our examination of burnout.

Stress gains power when the thing or problem causing the stress is important, uncertain or occurs over long periods of time (duration). Let’s look first at importance.  Think about our work with patients and clients.  We enter this profession because we care about the well-being of people and our communities.  The work we do is critical, both to the individuals we serve as well as to the overall health and safety of our communities.  In other words there might not be a more important job in our society than the one you are doing right now.  If you have not heard it today…Thank you for your dedication!

Next is uncertainty.  Do you have ANY ability to predict what will happen on any given day?  If your experience is like mine, just when you think you have seen it all something truly mindboggling walks through the door!  “Working with uncertainty” should be a line in all our job descriptions.

Finally, duration is an issue we all deal with in the helping professions.  Clients’ needs, e-mails, phone calls, paperwork and daily crises do not stop when we leave the office or take a vacation.  I have never had someone tell me “we have more resources than we know what to do with.” The reality of social services and public health is we work from a resource restricted position.  We do the miracles with what we have and use our creativity and passion to try to give our clients what they need to better their situation.  As long as this is our reality, we’ll always have too much on our plates and struggle to keep our heads above the constant demands of our work.

In other words, we work in high stress environments!  This reality means that exhaustion is a constant struggle.  Exhaustion is Stage 1 of burnout and something we have all experienced.  There exists a fine line between exhaustion from a bad day and the exhaustion associated with burnout. A bad day is something we can shake off by talking to a loved one or friend, having a great weekend, working out or practicing mindfulness.  Burnout is when we start waking up tired, driving to work tired, seeing clients/patients tired, and coming home tired.

The good news about exhaustion is that we can recover with a long weekend, vacation or focusing on activities that improve our well-being.  The challenge is, it is a very small step from Stage 1: Exhaustion to Stage 2: Shame and Doubt.  Exhaustion means we are not able to give our best to our patients and clients.  Since they are important to us we can easily feel shame that we are not providing the level of services we know we are capable of providing when we are at our best.

This shame can be a stress of its own. The additional stress can increase exhaustion, which increases our sense of shame, and a rapid cycle of stress can take over our lives.  In a matter of weeks we start to doubt our ability to provide great services we know our clients and patients need.

Here is where our work differs from many other professions in society.  When your job is to create widgets, being exhausted might not impact anyone in a meaningful way.  In the helping professions, when we do not bring our best selves to work, people can suffer in very real and tangible ways.  Dealing with high levels of importance, duration and uncertainty requires us to bring our best to work every day, and at the same time it depletes our emotional, cognitive and physical energy.  This reality can accelerate our journey down the stages of burnout.

We cannot exist long in a state of exhaustion, shame and doubt.  This can lead quickly to Stage 3: Cynicism and Callousness.  We harden ourselves in order to survive the stress.  If we know we cannot give our best, we put up emotional walls to isolate our psyche from the knowledge that we are not giving our clients what they need.  No one wants to be cynical or callous, and these traits can be devastating in work that requires a superhuman level of empathy and patience. We disconnect with clients and often isolate ourselves from our co-workers and people in our personal lives.

I have seen many people recover from Stage 1 and 2, but when a helper becomes cynical and callous they start to burn bridges with peers and clients.  I have yet to see someone stay in the same position in the same organization and recover from Stage 3.  It is possible, but it takes a lot of work and energy to rebuild relationships, and when one starts from a place of exhaustion and shame this can be a nearly impossible task. I have seen many people exist in this stage for years within an organization, leaving a path of destruction and pain in their wake.  One of the most damaging situations is when a leader is in Stage 3.  It can damage their staff and trickle down to how their staff treat clients and patients.

Stage 4: Failure, helplessness and crisis is rare to witness because most of the time the person leaves their job or is fired before they hit this stage.  When people hit this stage they are often alone and suffer in isolation.  The reality is that work can lead to broken relationships, mental illness, physical disease and a range of other problems.  Here is a slide from my research that lists all the consequence of burnout.

BUrnout (480x360)

I want to leave you with this thought.  We should not suffer because we have dedicated our professional lives to the service of others and our communities.  Each of us have made the choice to forsake riches and luxury to follow a higher calling to serve those in pain and struggling with traumatic pasts.  We have to take care of ourselves first, if we don’t we cannot help others and are at risk of doing harm to those that come to us looking for hope.  I would love to hear from you all on how you keep yourselves health and recover from exhaustion, please feel free to share your experience in the comment section of this post.

6 responses to “Why Helpers Burnout Out So Quickly (& Deeply)”

  1. Alexis says:

    Matt – as always I appreciated your post. I have found that taking care of myself includes not only spending quality time outside of work with the ones I love, exercising, eating right, and getting enough sleep, but also working with my own helper to ensure that I am addressing my own issues – both past and present. It is almost impossible for us to “heal” ourselves and there is no shame in reaching out and seeking for yourself the same type of assistance that you gladly and freely give to others.

  2. Alexis says:

    Matt – as always I appreciated your post. I have found that taking care of myself includes not only spending quality time outside of work with the ones I love, exercising, eating right, and getting enough sleep, but also working with my own helper to ensure that I am addressing my own issues – both past and present. It is almost impossible for us to “heal” ourselves and there is no shame in reaching out and seeking for yourself the same type of assistance that you gladly and freely give to others.

  3. joy taylor says:

    Thanks for continuing to write about the problem of burn out. I think just reading that all of us face this problem is helpful. I am trying more lately to manage my daily schedule. I think the Patient Center Medical Home open access has been helpful in this regard. Trying to keep my patient schedule open to take care of the people who walk through the door. Thanks again Matt. Keep up the good work.

  4. joy taylor says:

    Thanks for continuing to write about the problem of burn out. I think just reading that all of us face this problem is helpful. I am trying more lately to manage my daily schedule. I think the Patient Center Medical Home open access has been helpful in this regard. Trying to keep my patient schedule open to take care of the people who walk through the door. Thanks again Matt. Keep up the good work.

  5. Thank you for continuing with self-care and burnout. As a supervisor overseeing our Drop-in Center for veterans, we see distressed veterans of every type, including those in crisis at least once a week and which requires a 911 call. My staff are faced daily with helping veterans toward self-sufficiency. We can help many, but there are many we can’t help. Fortunately, my organization allows for mental health days and some staff do use it. (Me, too!) Keep up the great work!!!

  6. Thank you for continuing with self-care and burnout. As a supervisor overseeing our Drop-in Center for veterans, we see distressed veterans of every type, including those in crisis at least once a week and which requires a 911 call. My staff are faced daily with helping veterans toward self-sufficiency. We can help many, but there are many we can’t help. Fortunately, my organization allows for mental health days and some staff do use it. (Me, too!) Keep up the great work!!!

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