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Why do so many of us have work-related burnout and how can we fix it?

Rates of work-related burnout are soaring. The Health and Safety Executive published data in November 2021 to show that 2.5 per cent of employees are experiencing work-related stress, depression and anxiety. This is up from 1.5 per cent in 2002.

It is predominantly affecting those in education, healthcare and defense – the same keyworkers we clapped on our doorsteps and now applaud for supporting Ukraine. With such numbers – that wider likely underestimate the true spectrum of work-related stress – this can affect anyone, at any time.

The seriousness of the impact of burnout both for the individual and society at large has been recognized in the 11th edition of the International Classification of Diseases (ICD-11), which came into effect earlier this year.

They now recognize it as a syndrome resulting from chronic workplace stress that has not been successfully managed. It is characterized by three dimensions: feeling energy-depleted or exhausted; Feeling negative or cynical about one’s job and/or a sense of ineffectiveness and lack of accomplishment.

Covid does not seem to have affected the steadily climbing rates, perhaps due to the oft-reported benefit to wellbeing that remote working offered. However, the pending cost of living crisis certainly will as people take on extra work to make ends meet at home.

Furthermore, during periods of organizational stress, employee development and training is often the first resource to face the ax for the primacy of service delivery, and therefore workers’ sense of accomplishment.

We have a clear idea of ​​what the UK will face. Japan had to coin a new term, “Karoshi” for the tendency for employees to work themselves to death either from suicide or cardiovascular events such as heart attacks and stroke. The majority of coroner reports suggest that victims work upwards of 60 hours per week. This indirect way that over-work can damage one’s heart and brain is not taken into account by the HSE’s analysis.

Unfortunately, there is not an International Classification of Diseases for Organizations as yet. Perhaps we would all be listed there. As issues of systemic racism, gender disparity and nepotism are still underacknowledged, let alone addressed, people are spending the majority of their time in places that make them feel less of themselves, without being able to clearly understand why.

This needs to be resolved and it is right that toxic workplaces are being confronted with their own shadow as part of a multi-directional approach to reduce rates of burnout.

However, I’d also like to address the less-discussed issue which is the personal dynamics of the employee experiencing burnout. It is excellent news that with this new ICD diagnosis, people can now get streamlined access to appropriate, evidence-based help on the National Health Service for such problems.

A large barrier to seeking treatment will be people’s understandable resentment at being labeled as “sick”. However, not only can burnout resolve, but the individual can actually come out the other side a more rounded, individuated, version of themselves when it is processed appropriately.

One psychoanalytic theory regarding depression is that it is anger turned against oneself. I often find that people who are rightly angry against an uncaring institution end up feeling defeated and blame themselves for their situation. These are the employees that never flag up on a manager’s radar as concerning, despite considerable self-blame and judgment.

With therapy, they can come to harness their own anger and aggression and find helpful ways to channel it. That may be through unions, presenting their complaints more helpfully or redirecting them to someone who can hear. One of the effects of depression is that your thinking and motivation is dulled; solutions are opaque. Through thinking with an independent mind, one can reignite one’s creativity in solving such work-place related issues.

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Secondly, there is of course the question of why someone would stay in such a role. We all have sado-masochistic tendencies and these are apparent in many workplaces where you can feel either masochistically resigned to your lack of power, or addicted to the sadistic pleasures of power roles.

Some people oscillate rapidly between the two positions depending on the power imbalances in any given meeting. Sado-masochism is, if not a form of love, a way to feel intense connection with another. Many workers with burnout have not yet come to recognize that they are resigned to a workplace half-meeting a need that is missing elsewhere in their lives.

Leaving a toxic workplace is difficult. One must mourn the loss of opportunities and the fantasied riches that motivated one to start there in the first place. It is also common that people simply do not know themselves well enough to have it clear in their minds where they need to target their professional intentions. Coming to know oneself makes it easier to know one’s niche and then move towards it.

This is different from Mindfulness apps and corporate wellbeing programmes. There is a need for us to step beyond employee/employer dialectics into being two people acknowledging their own needs.

Dr Matthew Rinaldi is a junior doctor in medical psychotherapy and general adult psychiatry

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