Mapping the Descent into the Inferno
“Sometimes we need permission to surrender to the feelings of burnout in order to take stock, be gentle with ourselves, and begin to safely rebuild our lives Too many people these days keep powering through, toughing it out, until they collapse They don’t feel that they have permission to stop and put themselves first.”
— FACEBOOK FRIEND JAN CARMICHAEL DAVIES1
I wrote a first-person account of burnout in the Introduction to give you a taste of how it affects thinking, behavior, emotional experiences, relationships, and work in the world. But unless you’ve experienced burnout personally, you may not fully comprehend how serious this state of emotional exhaustion and loss of motivation can be, and how crucial it is to meet its challenge before you collapse into depression, addiction, or physical illness.
One of my FBFs kicked off an interesting conversation by commenting on how defensive she got when a friend told her that she was fried and that her lifestyle simply wasn’t sustainable. Another FBF concurred, adding that she used to think that being burned out was an admission that something was wrong with her. Now she views burnout as an invitation to come into alignment with a more elegant expression of her gifts, relationships, and overall life energy.
The late psychologist Herbert Freudenberger, who first popularized the condition in his 1980 book, Burnout: The High Cost of High Achievement, would have appreciated their conversation. Rather than a cause for shame, Freudenberger believed, burnout is a painful affliction of good people who are trying to give their very best. He defined it as “the extinction of motivation or incentive, especially where one’s devotion to a cause or relationship fails to produce the desired results.”2
Freudenberger and his colleague Gail North distinguished 12 stages as a general map of the territory that leaves plenty of room for individual variation. Some people endure all or most of the stages of burnout, and others experience just a few. Some go through them chronologically, while for others, they are simultaneous or occur out of order. From my own experience, both personal and clinical, the 12 stages of burnout are powerfully descriptive of the thoughts, feelings, and actions that define the syndrome.
The observations that Freudenberger made, drawn from extensive interviews, laid the foundation for the research that followed.3 He traced the progression of burnout from the first phase of wanting to prove yourself and do a good job to an escalating set of emotional, behavioral, and physical symptoms that accompany the realization that doing a good job according to your own definition or that of others is virtually impossible. Falling short of your ideal in any way—perceiving a gap between what you think is required of you and the reality of what you can produce—can be disheartening to the point where your entire sense of self crumbles.
The reality gap can open in a variety of ways: for example, the kind minister who finds himself under attack from a few troublemakers in the congregation who are impossible to please; the physician who is overworked and unable to practice the kind of medicine she signed up for; the social worker unable to handle her caseload and help her clients move forward in their lives; the eager worker unclear about his job description; the ecologist incensed when political horse trading kills off environmental initiatives; the hardworking parent whose child turns to drugs; and the list goes on. . . .
While I’ve stayed true to the stages of burnout that Freudenberger and North originally described, I’ve changed some of their names so they’re more descriptive. I’ve also added my own unique spiritual perspective. Since it’s so important to understand the patterns that propel the journey into the Burnout Inferno, this lengthy chapter is best approached as 12 minichapters. Take your time reading through each of the stages. When you’re finished, please read through them a second time; and then at your own pace, complete the “Self-Reflection Exercise” at the end of each stage, which is at the heart of your revival. Here’s a quick breakdown of the burnout stages:
| Stage 1: | Driven by an Ideal | |
| Stage 2: | Working Like a Maniac | |
| Stage 3: | Putting Your Own Needs Last | |
| Stage 4: | Miserable, and Clueless as to Why | |
| Stage 5: | The Death of Values | |
| Stage 6: | Frustrated, Aggressive, and Cynical | |
| Stage 7: | Emotionally Exhausted and Disengaged | |
| Stage 8: | “I’ve Morphed into What?” | |
| Stage 9: | “Get Away from Me!” | |
| Stage 10: | Inner Emptiness | |
| Stage 11: | Who Cares and Why Bother? | |
| Stage 12: | Physical and Mental Collapse |
Freudenberger characterized this stage as a compulsion to prove oneself.
I know the feeling. The year was 1981, and it was as busy a time as I can remember. My husband of that era (Miroslav, who is still a good friend) and I both commuted an hour or more each way to work. He was doing research in comparative immunology and teaching medical students at the Tufts University School of Medicine in Boston. I was doing research in human motivation and health with Harvard psychologist David McClelland. I was also studying for the licensing examination as a clinical psychologist and planning to open one of the country’s first mind-body clinics with cardiologist Herbert Benson at Boston’s Beth Israel Hospital.
We lived in a small rural community, focused on giving our young sons, Justin and Andrei, a healthy outdoor life. All of us tended the vegetable garden in the summer and solar greenhouse in the winter. In addition, a barnyard full of chickens, ducks, geese, pheasants, king pigeons, guinea hens, and peacocks required our considerable time and attention year round, as did our two horses. Then there was my elderly mother. If I missed our evening phone call, the next night I’d be met with steely silence followed by a comment like, “Oh, I thought you were dead.” She meant to be funny, but burned-out people quickly lose their sense of humor.
I was fiercely committed to my children, marriage, and the new field of behavioral and integrative medicine. Furthermore, I was at the stage when I still believed that it was possible to reach enlightenment now, in this very lifetime, if you meditated long enough and did sufficient amounts of yoga. But I just couldn’t pull it all off.
The kids hated that I was a working mom and told me so loudly and frequently. They would have gladly traded our nice house and all the animals for sitting at home with me in an egg-stained nightgown instead of being dropped off at day care to wait for the school bus. My marriage was faltering, my mother thought I was nuts, and I realized that a life of grant writing and research was not what I’d signed up for.
My relief valve? I ran at least 20 miles a week, and for every mile I ran, I allowed myself one cigarette. This was done on the sly . . . behind a tree or the garage, or in a parking lot on the way home from work. I sneaked those smokes wherever I could to numb the pain of burnout—of falling into the gap between the world I so much wanted and the reality of the world I lived in.
The FBFs, like Freudenberger, made note of the fact that people who have the greatest investment in projects and ideas are much likelier to burn out than those who are less attached to the outcome of whatever they’re involved in. Although commitment to a cause, a job, or your children may seem selfless and virtuous, there’s often an underlying ambition and motivation to prove your importance and worth that predisposes you to becoming fried.
Motivation is a complex and largely unconscious orientation to what we do and how we do it. Do we “do” from a sense of insufficiency, just to prove that we deserve to breathe air and take up space? Do we do to make a living, plodding along like an automaton? Do we like what we do, but do more than we’d like so that we can feed our family? Do we do out of guilt or penance, trying to be good? Or perhaps we are so fervent about our efforts simply because we feel called by a power that cannot be denied.
Sometimes it’s the passionate doers—those out to save the world or to save souls—who are the most prone to burnout. The late Trappist monk Thomas Merton wrote a famous letter to a young activist named Jim that addressed just this point. In it, Merton wrote the following:
You are probably striving to build yourself an identity in your work and your witness. You are using it, so to speak, to protect yourself against nothingness, annihilation. That is not the right use of your work. All the good that you will do will come not from you but from the fact that you have allowed yourself, in the obedience of faith, to be used by God’s love. Think of this more and gradually you will be free from the need to prove yourself, and you can be more open to the power that will work through you without your knowing it.4
Whether or not you relate to the religious context in which Merton wrote, he made a point that I resonate with deeply. The more attached I get to a particular outcome, the less that Life can flow through me. More often than not, synchronicity opens doors that I would have never imagined. But if I’m wedded to my own agenda, I’m likely to walk right past those doors without even noticing them.
It gets exhausting when you believe that you’re personally responsible for changing the world. Here is more advice from Merton as he advised the young man:
Do not depend on the hope of results. When you are doing the sort of work you have taken on, essentially an apostolic work, you may have to face the fact that your work will be apparently worthless and even achieve no result at all, if not perhaps results opposite to what you expect. As you get used to this idea you start more and more to concentrate not on the results but on the value, the rightness, the truth of the work itself.5
Self-Reflection Exercise #1: What Motivates Your Work?
First thing in the morning (for me, that’s after a cup of coffee!), pull out a notebook and pen. The unconscious is a natural neo-Luddite that expresses itself most authentically in longhand. The writing exercises I’ll describe in this chapter work best if you keep the pen moving on the paper and don’t stop to read or edit what you’ve written. This stream-of-consciousness approach taps into your authentic self, the part of you that is directly connected to the larger intelligence that Merton calls God—the primal energy of creativity.
Write for at least 30 minutes about what motivates your work in the world. Chances are those motivations are complex.
When I think about what motivates my mothering, for example, it’s partly biological, partly narcissistic in that I want my children to reflect well on me, and partly (and I like to tell myself that this is the biggest part) that I want my children to develop fully into their own selves so that they enjoy their lives and leave the world a little bit better than they found it. I also hope that they’ll be there for me if I’m fortunate enough to make it to old age. These are just a few of the layers of mother motivation that came directly to mind.
You can do this inquiry on motivation with any or all of your relationships. Next, try it with your work. For me, being a scientist, psychologist, author, and public speaker is its own mixed motivational bag. When I get attached to results (that this book makes The New York Times bestsellers list, for instance), I’m setting myself up for burnout. But if I can be content to “concentrate not on the results but on the value, the rightness, the truth of the work itself,” as Merton suggested, then there’s nothing to prove. There’s only a gift to be given.
What comes to you during this exercise is the starting point for transforming burnout to insight, and freeing your best self for work and for life.
Stage 2: Working Like a Maniac
This is the stage that Freudenberger described as “working harder” so that you can move closer to your goal. Most of us work harder on some occasions than at others, of course. I’m always relieved when our accountant, for instance—who seems to hyperventilate through the entire six-week run-up to April 15—relaxes at the end of another tax season. When I was in the business of conducting research on stress, accountants at tax time were often recruited as naturally occurring experimental subjects.
But there is no “high season” if you’re sliding down into the Burnout Inferno. Every day is busy and filled with stress when you’re intent on proving yourself.
Meticulous about your work, you may be unwilling to risk delegating anything you consider important so that other people can help you carry the load. A kind of grim determination takes over, a “do or die” attitude that leads to taking on more than can be realistically accomplished. In these days of budget reductions and downsizing, even individuals who aren’t motivated by idealism but just want to do their jobs reasonably well are feeling the squeeze. Many of the FBFs wrote about being assigned more work than was humanly possible to accomplish after colleagues were laid off. They admitted to being overly stressed out.
When I was working with Dr. Herbert Benson, he introduced me to the Yerkes-Dodson law, which makes the relationship between stress and burnout clear. Visualize a graph. Succinctly put, if you place productivity on the y-axis (the vertical line) of your graph and stress on the x-axis (horizontal line), you get an inverted U Productivity increases with stress—to a point But after that point, you find yourself in the land of diminishing returns. You’re working harder, but getting less quality work done. That’s when burnout sets in.
Here’s an example: The stress of working toward a deadline—whether it’s cleaning your house before company comes over or finishing a demanding work project— can be exciting and energizing. Intention focuses attention, and when the challenge of the assignment and your degree of mastery intersect optimally, the exhilarating state that psychologist Mihály Csíkszentmihályi calls flow takes over and you’re golden.
Flow occurs around the peak of the Yerkes-Dodson curve. But if the deadline you’re working toward is unrealistic, or if your level of mastery isn’t sufficient to meet the challenge, then you slide off the peak of the curve and down the descending limb. You’re working harder, but the quality of what you do isn’t your best. Your mental health isn’t that stellar, either.
Likewise, when you’re hovering near the edge, unforeseen problems (such as a fight with your spouse, your kids doing poorly in school, an illness, a tax problem, a death in the family, or even a new software program that you’re expected to start using at work) can push you into the abyss.
When I ran a stress-disorders clinic, I saw a lot of people who were very productive—including a lot of high-powered executives—even though they were stressed out and working on the burnout side of the curve.
By learning to back off and pay attention to their own needs, however, many of these individuals were able to bring a different, more balanced and mindful self to the office. Their leadership skills became more open and responsive as they moved back over to the ascending limb of the curve. Not only did their work still get done, but the quality of it was of a different caliber—more innovative, exciting, and evocative both of their talents and those of the people they worked with.
Moments of astounding flashes of creativity are filled with examples of breakthroughs that came by working less The French mathematician and physicist Jules Henri Poincaré, for example, experienced a major insight on a difficult formula while on vacation in the French countryside. We can all take a lesson from the science of creativity. Inspiration does indeed favor the prepared mind, but the Muse is courted by Lady Pleasure and scared off by cracking the whip.
If you take time out, amazingly enough, the world actually keeps spinning in its orbit, and you’ll do a better job. You’ll also protect your adrenal glands from burning out along with your own creative spark.
When I was doing research at Harvard, the head of the Sufi Healing Order came to Boston. I attended a weekend retreat with him to see what this ancient mystical school (the poet Rumi was a Sufi) might teach us about healing. Saul the Sufi healer affirmed that there are two very different ways to approach healing and life: powering through by pressing your own agenda, or relaxing into a larger source of energy that carries you along.
While walking along the beach with Saul, discussing whether or not healing energy could be measured in a laboratory, the conversation got personal. He could tell I was pushing so hard that my adrenal glands were working overtime. Why not back off and let universal energy come through me, he suggested, rather than manufacturing a more limited energy on my own and wringing my adrenal glands dry?
Why not, indeed? Prevention of burnout begins with becoming more mindful of your own physical energy system.
Self-Reflection Exercise #2: Minding the Energy Body
Your body is the most obvious place to begin shifting your relationship to energy. Right now, for example, I’m relaxed. A hike up the mountain with Gordie and the dogs, a hot shower, and meditation make for mellow. If I were to rate my stress level (1 being low and 10 being high), it would be a 3 at this moment. My body feels relaxed, open, and in balance. But, of course, that’s not always the case. If I didn’t know what 10 felt like, this book wouldn’t be of much use to you.
The key is not to reach for Level 1 and stay there, but to become a connoisseur of your changing physical sensations, which can then guide you. When I’m at a 7 or 8 on a 10-point stress scale, for example, I know that I’d better take a walk, relax, play with the dogs, or call a friend since I can’t focus well. Flow, that delightful state when your best work happens, occurs near the midpoint of the Yerkes-Dodson curve.
My colleague and friend Shannon Kennedy (also an FBF) is a Feldenkrais practitioner who has a lot to say about burnout and the body. Feldenkrais is a form of bodywork that enhances awareness of how you hold yourself and how the aliveness within you—your energy body—waxes and wanes responding to mental, emotional, and physical stimuli.
Shannon posted this during one of our discussions:
The body is where I would start to deal with burnout so that I wouldn’t need to take long sabbaticals to collect my parts and return them to their original location. So often we intellectualize and go to the mind to think things through, jumping right past the physical discussion our body is having right under our nose. My perspective is this: getting to know where you feel contracted in body, thought, and emotions and what it feels like to release that holding is the way out of burnout.
We are fluid, flowing beings, and when we are in nonstop mode, we are perpetually in a holding contraction, thinking that we are stabilizing. Our body is actually working overtime to support our mind’s directives, like a loyal canine companion. Because of this contraction, no blood/prana can flow.
When I ran a mind-body clinic, body awareness was one of the first skills we taught our patients. Simple progressive muscle relaxation—tensing and relaxing your body methodically, part by part, from head to toe— trains you how to notice muscle tension and its relation to energetic vitality (what Shannon referred to as prana).
Whether you purchase a guided muscle-relaxation CD (try my Meditations for Relaxation and Stress Reduction) or sign up for Feldenkrais lessons or mindfulness, tai chi, or yoga classes, these disciplines train body awareness. In a matter of weeks, you’ll become a budding connoisseur of subtle body sensations.
Here’s one thing you’re sure to notice. When you get into the mental mode of needing to achieve and to prove yourself, pressing an agenda and squeezing your adrenals, you’ll tense up and cut off the flow of prana and creativity. When you let go, you’ll automatically relax and gain access to your inner wisdom. Taking care of yourself is the most important part of taking care of business.
Stage 3: Putting Your Own Needs Last
FBF Jeanette Pintar posted this comment that describes what happens when you’re constantly putting your own needs last:
But how can I take care of myself when I must get all this stuff done?! That’s my first clue that I’m burning out . . . that and all the lightbulbs around me start to burn out! Defensive? Offensive? Just plain whiney and cranky? Those are good clues, too.
I have to remind myself to step away from the computer, step away from the to-do list, put the guilt trip down, and ditch the martyr syndrome. I take a salt bath, walk the trails, or go to the beach. I at least go out for a cup of coffee or drinking chocolate and take a few minutes to reset. The irony is that in taking more time for me, I seem to get everything else done with more grace, ease, passion, creativity, energy, and enthusiasm in much less time than before.
Jeanette is doing well because she has learned to catch herself in the act of putting her own needs last. If you don’t catch yourself, this is the stage of burnout where your physical body and mental health begin to quickly lose ground because you’re too busy to tend to your well-being.
Good-bye exercise, hello belly fat. Good-bye movies and walks in nature that provide relaxation, enjoyment, and the shift to right-brain thinking that favors creative breakthrough and conscious contact with a larger source of intelligence. Good-bye time with family and friends. You exhaust yourself in doing, doing, doing. Thus the popular saying: “Put on your own oxygen mask before helping anyone else.” That advice, however, makes me see red when I’m “initialized” (taken over by relentless deadlines and working myself into a frenzy). It interrupts my need to achieve and creates anxiety, which I instantly convert into irritation.
This is when one of my girlfriends—I’ll call her Gayle—reliably starts calling me a “human doing.” That phrase, like the oxygen-mask metaphor, annoys me to no end. (And since I’m generally a kind, easygoing person, being annoyed is another surefire indication that I’m burning out.) I get defensive. I compare myself to much busier people—Hillary Clinton comes directly to mind—who are so enthusiastic about what they do that the term fried apparently doesn’t apply to them, at least in my imagination. If you asked her (or Bill), perhaps they’d tell you a different story. But I use Hillary and other apparently indefatigable role models as an excuse nonetheless.
On the other hand, what if someone had accused Benjamin Franklin of being a human doing on the verge of burnout, for example? Just as he was gearing up to fly his kite in a thunderstorm and discover electricity, my friend Gayle might have said, “Relax, Ben, before your blood pressure goes through the roof. You work too hard. Just look at those bags under your eyes and that enormous paunch! You need more exercise and sleep. You have to take better care of yourself. Maybe you could learn to meditate and reduce your stress.”
My fantasy is that Franklin might have rolled his eyes, patted his ample girth, and laughed until he cried. Then, perhaps, he might have grabbed Gayle by the hand and taken off running into the storm. Enthusiasm, of course, is an antidote to burnout. It’s medicine for the soul—the place of flow where doing and being are one. And although I might wish that Hillary Clinton had more time for herself, she’ll likely outlive us all because so much life-force energy moves through her.
The etymology of the word enthusiasm can be traced to the Greek root entheos, which means “in God”—inhabited and guided by the life force itself. The operative question to ask when you aren’t taking time for yourself is whether you’re inspired like Benjamin Franklin or Hillary Clinton; or emotionally drained, overdriven, and exhausted. To avoid lying to yourself and getting defensive (which you can already appreciate is typical of burnout), you can pose the question in another way: Am I having fun and enjoying life?
Self-Reflection Exercise #3: Are You Having Fun Yet?
On a scale of 1 to 10 where 1 is feeling like Ebenezer Scrooge on a bad day and 10 is like Robin Williams, what’s your joy-in-life score? Write it down, because you’ll need to return to it later to see how your revival is coming.
One evening while writing this book, I was a guest on the Inspiring Women Summit, a teleseminar conference. The other two guests were my colleague Christiane Northrup, M.D., an obstetrician-gynecologist whose current work in women’s health is all about pleasure; and her teacher of pleasure, the inimitable Mama Gena (Regena Thomashauer) who runs the renowned Mama Gena’s School for Womanly Arts in New York City.
“What are you wearing?” Mama Gena asked us. She was wearing a feather boa, lace teddy, and something silky and slippery around her loins. Seated amidst multiple glowing candles, Mama Gena was certainly practicing what she preaches and apparently having a lot of fun. Christiane reported that she was wearing tango shoes with four-inch-high red heels. I, on the other hand, was completely resplendent in my droopy sweats while sitting at the computer.
We had a wild time. When I wasn’t editing my language for posterity (the series was recorded), it was actually great fun, although I realized what a prude I am. I was actually holding my breath while Christiane and Mama Gena waxed ecstatic about that tiny marvel of feminine anatomy—the clitoris—and its 8,000 pleasure-happy nerve endings.
“How does it feel down there?” the two Pleasure Mavens inquired. “Is your pelvic floor feeling alive?” Although I sat blushing in my less-than-sexy sweats, it was impossible to avoid taking stock of the state of those 8,000 nerve endings. I understood their point perfectly well. The organs of reproduction (no matter which sex you belong to) are the seat of your life-force energy. If things are dead down there, it’s a signal that you’re running out of gas in the rest of your body and your life.
Mama Gena offered this advice: You don’t revive from burnout by thinking about it and dissecting your problems. You have to wake up through pleasure and fun. Joy makes you more enthusiastic about life. And as Dr. Northrup pointed out, pleasure increases the amount of nitric oxide in your blood, which enhances cardiovascular health and general well-being.
So . . . tango, anyone? What fun are you looking forward to? Try scheduling one pleasurable activity every week for the next three months. Put those dance lessons, hikes, camping trips, romantic dinners, evenings out with the girls or guys or couples, or whatever you can dream up on your calendar. Even if (especially if) you don’t want to follow through, make the effort, and then at the end of three months, go back and revisit your fun score. If it hasn’t changed, you may have to visit Mama Gena’s School for the Womanly Arts or whatever the masculine equivalent may be.
Stage 4: Miserable, and Clueless as to Why
FBF Laurie Line didn’t even realize that she was burned out until losing her job gave her the time to take a breath and notice what she was actually feeling. Here’s how she described the experience:
When my burnout became apparent after being laid off, I was finally able to slow down and realize that I had been selling my soul for unending deadlines and always being the go-to person for everyone else’s needs. In the middle of it, I believed that things would get better after the deadline, after I crossed something off my list, and so on. However, the universe knew that the only way for me to see clearly was to have a long break away from the craziness.
A friend of mine who is an obstetrician was as clueless as Laurie about why she was so out of sorts. To compound the problem, “Jenna” did what a lot of stressed-out people do: she looked for someone else to blame for her feelings. It must be her husband! “Steve” could be more attentive when she came home from work and more intimate before bed (and while in it). He could take up more of the slack around the house, too. After all, wasn’t he supposed to be her other half, her soul mate who would make everything right with the world? Obviously, Steve was shirking his marital responsibilities. But her husband wasn’t the problem; it was Jenna’s burnout that was talking, rather than her good heart.
Like many couples, Jenna and Steve had some wrinkles to iron out, but from Steve’s point of view, his wife’s constant fatigue and defensiveness made it hard to be intimate. He felt that she just wasn’t the same energetic, fun-loving woman he’d married. Moody, touchy, and exhausted, Jenna was difficult to be around because she was consistently negative.
The underlying reason for Jenna’s burnout was a double bind—a “damned if you do, damned if you don’t” kind of work situation. She loved being an obgyn and had put off having children of her own in order to give other women safe passage through pregnancy and birth. Jenna’s clientele consisted of high-need, high-risk cases—women who were experiencing the stress of infertility as well as those who were at risk of not being able to carry their babies to term.
Jenna loved these women as if they were her own family. She was dedicated to long appointments so that she could inform, reassure, and motivate her patients to do whatever might be necessary to ensure a healthy pregnancy. How could she allot 15 minutes to a woman who’d recently lost a baby at four or five months’ gestation? But as the cost of her malpractice premiums rose, she was forced to schedule more patients for shorter visits just to make ends meet financially. Eventually, the strain of being pulled between taking good care of her patients and attending to her own needs became unbearable.
With the help of her husband and a therapist, Jenna finally made the difficult decision to leave her practice and take six months to rest and reflect on her life. As I write this, she’s nearing the end of her sabbatical and planning to take a part-time job at a Planned Parenthood clinic. She’ll still be able to care for women who need her but without the stress of the high-stakes, high-risk practice she’d been in before.
Self-Reflection Exercise #4: What’s Going On in Your Life?
If you’re feeling frustrated, aggravated, or disempowered, and if you catch yourself always blaming other people for your problems or complaining about their performance, you need to connect with what is really going on. Is it them, is it a situation that requires a change, or is it you? You need a real time-out to evaluate your life, even if it’s not a six-month sabbatical like Jenna’s.
Taking the time to sort through what you’re feeling is hard to do in familiar surroundings when you’re moving at the speed of light, out of touch with your body and emotions. The ringing phone, ceaseless e-mails, household chores, work issues, and all your relationships are distractions. Fortunately, you can visit what are aptly called “retreat centers” all over the country. Since I often give workshops at such places, I’ve sampled the spectrum from five-star spas to two-star retirement communities for nuns who rent out rooms to the public.
When I lived on the East Coast, and had just left my job at the hospital after being in a head-on collision (which was due to burnout), I went to several weekend retreats at a Benedictine monastery about ten minutes down the road from my house. There was no program; it was simply a place of refuge at a price less costly than feeding myself at home. The accommodations were spartan but clean, and I was alone—no kids, no husband, no business to conduct. Jesus was there, of course—at least in spirit—but he and I did our own thing.
I’m Jewish by birth and spiritual but not religious, yet that retreat was perfect for me. I was free to explore the beautiful trails, and was fed three meals a day. My room was pleasant and a good place to meditate, journal, or just read a mystery novel and relax. Furthermore, I didn’t have to talk to anyone unless I wanted to.
Both of the Canyon Ranch sites (beautiful spas located in Lenox, Massachusetts, and Tucson, Arizona) are oases with access to nature, healthful food, state-of-the-art wellness and exercise programs; and practitioners such as physicians, bodyworkers, exercise physiologists, psychologists, and spiritual mentors. Less-expensive retreat centers that offer excellent programs are the Kripalu Center for Yoga & Health in Stockbridge, Massachusetts; the Omega Institute in Rhinebeck, New York; the venerable Esalen Institute in Big Sur, California; and my all-time favorite place on the planet—the Hollyhock retreat center on beautiful Cortes Island, British Columbia. Several of these places also offer work-study programs. Over the years, I’ve met some very interesting people—from corporate executives to health-care providers, students, and homemakers—who were taking a break from their lives by affording themselves these types of opportunities.
If you search the Internet, you’ll almost surely be able to find a retreat center that fits your budget. Take out your calendar and make those plans now. Otherwise, your busy life will just keep rolling along until you finally crash emotionally or physically . . . or, like I once did, quite literally.
My friend Tom Zender is a minister, author, and business consultant with very strong values. One reason why he doesn’t burn out is reflected in a comment he made on my Facebook page. It was in response to a discussion on how getting sick is often the only way in which busy people can get a rest. Tom wrote: “We’ve got to block out at least an hour per day for meditation, silence, prayer, reading, journaling, exercise, communication with family and friends . . . er, make that two hours, Joan!”
Well, I know that all of those things are important, and I not only subscribe to them, I teach them. But when burnout takes over, values get shoved aside so that you can spend every minute working. Priorities shift from living a balanced life to chasing an unobtainable moving target. A good example of this is in the movie Avatar, where a degenerate culture (which was modeled on our own) was willing to destroy a peaceful planet (which was in tune with the natural world) in order to excavate a mineral aptly named unobtanium The metaphor wasn’t lost on me, nor was it lost on the millions of others inspired by this mythical film.
When you’re single-mindedly chasing after your own unobtanium, you eventually flatline—effectively becoming deadened to the richness of life unfolding all around and within you. The little blips of joy, relaxation, fun, and spiritual refreshment that give meaning and texture to life disappear. When I’ve been in this state, nothing seems to matter anymore. I don’t care about going to the movies, seeing family and friends, exercising, getting a massage, gardening, or even talking back to the hypocritical politicians (the ones who tout family values while cavorting with their mistresses or bash homosexuals while having same-sex lovers) who populate the television news. Now that’s a dire symptom. It’s as if all of my interests and pleasure receptors have dried up and fallen off.
The technical name that Freudenberger and North gave this stage is revision of values In other words, what was once vital to you no longer matters as much. Work has swallowed your life whole.
I know I’m flatlining when Thanksgiving is coming up and instead of making plans to travel and see the kids, I decide to work over the holiday weekend. I know I’m flatlining when I stop wanting to take care of the plants and delegate the job to my husband. I know I’m flatlining when the sight of skis in the closet awakens zero interest in going out on the slopes. I know I’m flatlining when meditation, exercise, being in the kitchen, and going shopping for anything—from food to clothing to gifts—feels boring. I am definitely flatlining, and practically dead, when I lose interest in sex.
How do you recognize when you’re flatlining?
Self-Reflection Exercise #5: What Did You Once Enjoy Doing?
When I was a kid, we lived about three blocks from a bowling alley. I’d been initiated into the joys of duckpin bowling by my older brother, Alan (duckpins are the smaller pins found mostly at bowling alleys on the East Coast). Because the balls are also smaller, even children, given enough practice, can get really good at the sport.
I lived to bowl, which is where most of my allowance went.
As I grew older, bowling became less important, but unbeknownst to me, those narrow lanes had left corresponding grooves in my neural circuitry. Many years later, when I’d flatlined once again, Gordie and I happened to drive past a bowling alley. He turned the car around and pulled into the parking lot despite my protestations that I had too much to do and didn’t like bowling anyway. However, the simple act of picking up a ball and rolling it down the alley reawakened youthful neural networks primed by possibility, and soon I was laughing and having the time of my life.
You may not remember the joy you once felt in a hobby or activity that has fallen off your radar, so you may need to enlist a friend or loved one in helping you remember. One of my friends who is in her 70s was a dancer in her youth. During a flatline period of her own, she noticed a jazz dance class at her gym and signed up. It was as if a light switch were turned on inside her.
In 1979, Harvard professor of psychology Ellen Langer conducted a fascinating study of how we can improve well-being by doing things we enjoyed in our younger years. She calls it her “counterclockwise study,” and you can read more about it in her 2009 book, Counterclockwise: Mindful Health and the Power of Possibility Langer and her colleagues invited two groups of men in their late 70s and early 80s to live in a meticulous re-creation of the year 1959 for one week each. They transformed an old monastery in Peterborough, New Hampshire, into a living time capsule of the world as it was 20 years earlier.
One group was instructed to pretend that the year really was 1959 and talk about “current” events like Castro’s victory in Cuba and Nikita Khrushchev and the Cold War in the present tense. The other group spoke of events in the past tense more as observers than participants. All of the volunteers were tested physically and cognitively before the study began and again at its conclusion. While both groups showed increases in strength, flexibility, memory, and intelligence, the group who had acted as if it were really 1959 improved the most. Living like younger versions of themselves actually rejuvenated the men, demonstrating the profound effect that our thinking has on our body.
Think back to a time before you were burned out— when you were at your prime and filled with enthusiasm for life’s possibilities. What did you enjoy doing? Choose one activity (like bowling, for example), and put it on your calendar. This is an experiment. If it rejuvenates you, add it to your regular schedule. If it doesn’t, choose another activity from an earlier time in your life. Make sure to get out your calendar and actually add this to your schedule.
Stage 6: Frustrated, Aggressive, and Cynical
Humorist and author Loretta LaRoche and I used to give a workshop together that we called “Twisted Sister and The Fairy Godmother.” The Fairy Godmother is your idealized self—in the case of women, that usually translates to being sweet, long-suffering, and deeply concerned for the well-being of others. Twisted Sister is her shadow, the “Bitch in the Basement.” If you’re a guy, you have your own ne’er-do-well equivalent buried in your subconscious. Neither the idealized self nor the shadow is your authentic self—your soul—which is alive, changing, and appropriate to the moment.
The idealized self—the mask you put on for appearance’s sake—reaches the breaking point during burnout. All that work to maintain the facade, and it couldn’t even deliver the goods. You still don’t feel happy and fulfilled. As a result, the false self finally falls off and shatters like a mirror dropped on a tile floor. Then the Bitch (or Bastard) in the basement—the equivalent of the infamous Mr. Hyde—is free to come out and wreak havoc.
This is the point at which you may start yelling at your computer with gusto or devaluing a colleague. The burned-out businessman may focus on the assistant he’s always respected and begin to think that he’s inept: Jason takes forever to produce a simple report! But being disgruntled with Martha is only the tip of the volcano. Underneath a false veneer that is becoming progressively more difficult to hold together, the pressure of frustration is steadily building.
The inner dialogue of a person at this stage is cynical at best, aggressive at worst: The management around here has its head up its ass! That guy who everyone thinks is so great is a #@*&! charlatan Nice guys finish last around here, so why bother trying to do things right?!
Regardless of what may be happening around you that’s troubling, the biggest problem at this stage of burnout is your own attitude. The good Dr. Jekyll is slowly transforming into the evil Mr. Hyde. You have now succeeded in creating hell not only for yourself but also for the people around you. You’ve managed to block any real recognition that the situation could be much different if you changed.
One of my quarrels with some forms of therapy (I thank my friend and colleague Lee McCormick for this perspective) is that they are aimed at making life in hell a little bit more comfortable. But what is required at this stage of burnout isn’t a new pad for the floor of the tent you’ve pitched in the Inferno; it’s packing up and moving on. This requires an authentic curiosity about how you are using your energy.
Self-Reflection Exercise #6: Are You Using Your Energy Efficiently?
A trout catches the majority of its food near the center of a stream. If it swims too far toward either edge, it will use more energy than it takes in and die as a result.
If you’re feeling like a tired trout, it’s time to take your personal-energy economy more seriously. You’ll need to identify what drains you (checking e-mail more than once or twice a day, letting friends or clients suck you dry, signing your kids up for too many activities, spending more money than you need to, and so forth) and what helps you increase the impact of your energy (concentrating on certain aspects of your business, car-pooling with your neighbors, or setting healthy boundaries and enforcing them, for instance).
After you read this section, plan a 30-minute morning writing exercise. Your task is to identify better and more conscious ways to manage your energy. This works best if you’re specific, so identify three ways in which you waste energy and three ways to leverage your energy.
Several years before writing Fried, I’d signed a contract with another publisher to write a book about slowing down. Unfortunately, I was moving so fast during that period of my life that I couldn’t make the time to do it and finally had to return the advance. That’s irony for you. Meanwhile, the editor who had recruited me for that project found another person who really knew something about the art of slowing down. His name is Timothy Ferriss, and he wrote a completely dazzling book called The 4-Hour Workweek, which is definitely worth reading and putting into action.
Ferriss helped me realize that I was spending too much time on projects that had too little impact. His discussion of Pareto’s law, also known in business as the 80/20 Principle, can change your life. The gist is that 80 percent of the effects you get come from 20 percent of the effort you make. For example, 20 percent of your clients may order 80 percent of your widgets; 20 percent of your time spent on social networking might yield 80 percent of your new business; and 20 percent of your time used to exercise, eat well, be with family, and restore yourself may generate 80 percent of the joy in your life.
I checked out the 80/20 rule regarding my public-speaking business. Most of my income does, in fact, come from a minority of my speaking gigs. One-hour keynotes pay well, have the maximum impact in terms of the number of people I reach, and take relatively little time overall. Teleseminars may turn out to be better still, since there’s no travel time involved. On the other hand, providing a five-day workshop in a remote retreat center that draws few participants consumes a full week (traveling there and back, as well as preparation) and yields little income. I sometimes choose to do these retreats, but I don’t delude myself by calling them business. If they don’t return energy to me in the form of enjoyment, I’ve made a bad bargain.
Every one of us has different leverage points and energy drains. The challenge is to really sit down and identify yours—and then do something about them.
Stage 7: Emotionally Exhausted and Disengaged
As burnout progresses, you possess less and less energy and vitality. The false self has shattered and the resulting emptiness is dispiriting. When your old identity has fallen away and a new one (hopefully, your authentic self) hasn’t yet appeared on the scene, you’re left without any sense of self. Emotionally drained and deadened, exhaustion takes over. There’s barely a drop of energy left in you to give to anyone else, and the only respite, paradoxically, is work. Even though you’re less efficient and creative than you used to be, your job is something to hang your hat on.
The natural urge at this stage is to isolate and withdraw from friends, family members, and other connections. Individuals who are fried are notorious for feigning illness, taking “mental health days” or actually getting sick. Absenteeism, due largely to health problems, is an enormous drain on the U.S. economy. Mark Pauly, a professor at the University of Pennsylvania’s Wharton School, is co-author of a 2006 study that estimated the cost of absenteeism at upwards of $74 billion annually. When you take into account the fact that the great majority of doctor visits are for illnesses or conditions related to stress, it’s easy to see why many large corporations are vigilant in the detection and treatment of burnout.
When you reach the stage of withdrawal and isolation where illness becomes a serious issue, drugs—legal or illegal—frequently compound the situation. When you’re in emotional or physical pain, it’s only natural to want relief. That may come in the form of pain-relieving drugs, sedatives, anxiolytics (anxiety-reducing drugs), narcotics, tobacco, or alcohol. Unfortunately, these solutions often turn into addictions that create significant problems in their own right.
Isolation is a dangerous phase since personal interactions not only function as checks and balances on behavior, but they’re also a necessity for maintaining health and emotional well-being. (If you’re holed up every night slowly drinking yourself to death, you’re more likely to get help if someone knows what’s happening.) Social support strengthens immunity, releases feel-good hormones, helps protect cardiovascular health, and keeps the ship of life afloat. Humans are relational animals, which is why the stage of isolation is dire. At this point, reestablishing your social connections is a priority.
Self-Reflection Exercise #7: Who Do You Tell the Truth To?
Sometimes the person you’re most intimate with and can tell the truth to is your spouse, especially if you’re a man. One of the reasons why men have an increased incidence of illness and death after they’re widowed or divorced is that, in a majority of cases, their wife was their primary confidante. When she’s gone, their support system goes with her, and so does their health.
Women, in general, have a wider social support network so that even after the death of a spouse or divorce, statistically speaking, they remain healthier and more emotionally stable. But regardless of gender, the need for intimate communication and honesty is vital for health and well-being. In the latter stages of burnout, the need for social support is of paramount importance. A friend, coach, or therapist is an absolute necessity to keep from completely losing your way. If you don’t have the support you need right now, make a plan to get it
Stage 8: “I’ve Morphed into What?”
You may walk into your living room one day and find a group of family and friends sitting around waiting for your arrival. Is this a surprise party? you wonder. Then someone walks out of the kitchen—a stranger with a solemn face bearing neither food nor gifts. You suddenly get it. This is an intervention. Not just a friendly sit-down pulled together by a few loved ones, but an organized attempt to get you into a treatment program ASAP because you have now morphed into a bona fide addict.
But substance abuse is not the only substantial change that friends might notice about you. At the height of my last burnout episode, my friend Gayle took me to lunch to tell me that she was seriously worried about me. I was not at all myself. I was withdrawn; emotionally overwhelmed; cynical; fearful; and in her words, in danger of a “total nervous breakdown.” At the time, I was running a school to train spiritual mentors, writing a book with my husband, and traveling extensively to teach. Yes, I agreed, I was emotionally exhausted and scattered, but who wouldn’t be under those circumstances?
Denial and defensiveness are common throughout the burnout continuum since our entire way of life is on the line. It’s nothing short of amazing how fiercely we will defend our pitiful piece of real estate in hell.
But Gayle wouldn’t have any of it. She confronted me squarely, pointing out that lately I was either preternaturally calm, like the air before a thunderstorm, or emotionally explosive. “Your life is absolutely not sustainable in this way,” she concluded, delivering a clear and powerful friend-to-friend intervention. And that was the truth.
The spiritual-mentor school that I was heading up had me in a dilemma due to a conflict between two of the principals, both of whom I loved. In addition to that, a school is a place where multiple interpersonal conflicts are likely to arise, and I—Queen of the Conflict Averse—am simply not configured to deal with them. Harry Truman once famously quipped, “If you don’t like the heat, stay out of the kitchen.”
It took another six months for me to realize that I needed to close the school to save myself. And when I did, my energy started to return almost immediately. It was as if I’d been stretched out on a medieval torture rack and someone had finally loosened the screws. What a relief! In no time at all, I recovered and became my old self again. (Well, not quite, since I’m much more careful about avoiding similar situations, as you’ll read in the upcoming chapter on burnout-prone temperaments.)
As FBF Gina Vance put it: “We are in relationship with whatever/whomever we are burning ourselves up and out and down with.” Ending that relationship, though very difficult, saved my life. The color returned to my cheeks, and I no longer looked or felt like Quasimodo, much to my relief and that of my family and friends.
Self-Reflection Exercise #8: What, Who, and Why?
If whatever is burning me out could be put aside right now, what would that be? Who would I be without that situation? What’s stopping me from letting it go? This interrelated triad of what, who, and why is another 30-minute writing exercise. As you think about these questions, take a few deep breaths and connect with your body. Where do you feel tension, heaviness, or discomfort? As you imagine letting go of the situation, what happens to your body?
Here’s a good example of someone who profoundly changed his life after doing the self-reflection exercise and following through. “Jake” was a police officer with multiple physical symptoms: he had gastritis (which causes stomach pain and trouble with digestion) and experienced body aches, insomnia, and intense fatigue. He got anxious every time the dispatcher sent him on a call. Worse still, Jake started to feel like he was losing his edge and becoming a danger to himself and his partner. He was frustrated and angry, and doubtful that things would get any better. There was just too much to do, too few resources, “a lot of lip” (as he put it, from civilians and the media who don’t understand what it takes to be a cop), and very few rewards. Furthermore, the work was dangerous and didn’t pay particularly well, so Jake also had a second part-time job as a security officer at a bank. He was dining largely on fast food, he missed his family, and he admitted to feeling like he was at the end of his rope.
When Jake did the self-reflection exercise, he realized that letting go of his part-time job would be a huge relief. He could feel the weight sliding off his shoulders just by thinking about it. The why he couldn’t let go of, however, was the financial aspect. With two kids and a wife to support, he needed the extra income. But when he discussed quitting his second job with his family, they were unexpectedly understanding and supportive. They all agreed that it was far worse to see Jake suffering (and to worry daily about his physical and mental health) than it would be to simplify their lifestyle radically.
Moving to a smaller house, cooking all their meals from scratch, and shopping for clothes at Goodwill would indeed require a major adjustment. But the result was a life far richer in the things that matter most— Jake’s improved health and peace of mind, his ability to do his primary job well, and a happier family.
People who no longer do their jobs well or simply don’t care anymore are suffering from depersonalization This “screw it” (or sometimes “screw you”) attitude is one of the three measurement scales on the Maslach Burnout Inventory (MBI). The MBI, created by Christina Maslach, one of the pioneering researchers of burnout, measures the three major components of burnout: depersonalization, emotional exhaustion, and diminished personal accomplishment.
When you’re submerged in the “Get Away from Me!” stage, you start to act with hostility or disinterest toward the very people you’re supposed to be helping, seeing them as problems rather than as individuals who need you. You’ve already lost the connection to your own soul—you’re emotionally blunted, miserable, and feeling helpless to change your life. The result is that you can no longer relate to the essential humanity of others.
Depersonalization in the medical field, which we’ll use as an example, is called compassion fatigue This is what it looks like: I was a young faculty member in the department of anatomy and cell biology at Tufts Medical School in Boston in the mid-1970s. Justin and Andrei, my two sons, were little guys back then. I’d strained a muscle in the upper-right quadrant of my back lifting them in and out of car and bike seats, backpacks, and cribs. When the strain was still bothering me a few months later, I sought out the faculty health-care services.
I walked into a waiting room so drab and depressing that it could have been located in the Gulag. It was freezing, too. But when I entered the consulting room, I could easily have fainted from the heat. Directly next to the doctor’s desk was a space heater that was churning out sufficient BTUs to roast a flock of turkeys. The 30-something doctor was abrupt and dismissive, radiating waves of emotional exhaustion. I had to resist the ingrained urge of the helper to grab her by the hand and take her out to lunch where we could talk as two equals rather than as a burned-out doctor to a patient. She obviously needed more help than I did.
“What’s bothering you?” inquired the depressed doc while distractedly pulling lint off her sweater (her internal thermostat must have shorted out along with her compassion). I was clearly an inconvenience that she’d rather not be bothered with. I explained my symptoms anyway, ending with the simple question: “How long do these muscle strains usually take to heal?”
“Let me examine you first,” she replied, and I thankfully peeled off my sweater. I was nauseated from the heat. She poked around my spine a little, and I asked again, “How long until this heals? Do I need physical therapy or some sort of exercise program? Should I stop doing yoga for a while?”
“I don’t really know,” she answered flatly. “It could be cancer, after all.” As a cancer cell biologist and anatomist, my knowledge trumped hers hands down. What an insensitive (not to mention ill-founded) comment to make to a patient! Fortunately, I knew better, but I immediately thought of the emotional damage that she could inflict upon someone who was less well informed.
This young physician obviously didn’t give a damn anymore. Her cynicism and depersonalization were so advanced that the result bordered on sadism. She did give me a laugh, though, when she fetched a long ACE bandage and wrapped it around my torso so that one breast ended up pointing north while the other pointed south. Her doctoring didn’t lead to my relief or to a great sweater look, so I made my way to the ladies’ room and unwrapped my mummified midriff. The visit was a waste of time for the muscle strain, but it was a sad lesson about what can happen when a heath-care provider burns out.
A 2004 study published in the prestigious Journal of the American Medical Association (JAMA) suggests that a significant number of physicians are suffering from burnout. The investigators combed the literature for studies of burnout conducted with the Maslach Burnout Inventory and concluded that the evidence “suggests that the components of burnout may be common among practicing physicians, with 46% to 80% reporting moderate to high levels of emotional exhaustion, 22% to 93% reporting moderate to high levels of depersonalization, and 16% to 79% reporting low to moderate levels of personal achievement.”6
One of the unfortunate effects of burnout in physicians is dropping out. Just imagine the pain of training for 8 or 12 years at great expense both personally and financially, and then feeling so fried that you give up your profession.
Burnout is an aspect of health-care reform that, in my opinion, needs to be put at the forefront. No matter how well our medical system is funded, if practitioners are fried, their ability to deliver compassionate, excellent care is diminished. Burnout-prevention programs that are instituted in medical or nursing school could make a significant difference to the quality of health care in our country. They need to be based on compassion for oneself—learning what my colleague Cheryl Richardson calls “extreme self-care.” Without knowing how to take care of ourselves, the art of caring for others simply cannot flourish.
Self-Reflection Step #9: Compassion Meditation
If you’ve lost compassion for yourself, it follows that you’ll lose it for others as well. Tibetan Buddhists have used specific meditations to cultivate compassion, or bodhicitta, for the last 1,700 to 1,800 years. When the stock market crashed in the fall of 2008 and the United States entered what has been called the Great Recession, Dr. Sanjay Gupta, the medical correspondent for CNN, suggested that viewers learn compassion meditation to calm down and counter stress. At that time two new studies (one out of Emory University and the other out of the University of Wisconsin at Madison) demonstrated that compassion meditation could relieve stress; enhance well-being; reduce the inflammatory response, which predisposes us to a variety of illnesses; and even change the happiness set point in the brain.
Compassion meditation begins with sending blessings of loving-kindness to yourself, much as a parent would feel toward his or her beloved child. A basic form of this meditation is: May I be at peace, may my heart remain open, may I be happy, may I be well After you’ve generated compassion for yourself, send it to your friends, family, co-workers, strangers, enemies, and finally, to all beings.
(You can learn how to practice compassion meditation using my CD Meditations for Courage and Compassion, which I released in 2009 as a companion to my book It’s Not the End of the World: Developing Resilience in Times of Change.)
FBF Laura Flanders wrote this during one of our discussions:
Coincidentally, a friend posted a quote by Sam Keen right before you on my news feed: “Burnout is nature’s way of telling you you’ve been going through the motions but your soul has departed; you’re a zombie, a member of the walking dead, a sleepwalker.”
The feeling of having lost yourself is hard to describe, and harder still to live with. The essence of who you are—the way you see the world, your hopes and dreams, your little quirks, the tenderness that you have toward the ones you love—seems to vanish when you’re fried. All the attributes of personhood through which you relate to the world disappear as burnout progresses. Who are you when all that goes missing?
The chasm that separates you from life is so vast at this point that stimulation of any kind has to be especially intense to generate any feeling at all. Cruising the Internet for porn, having an affair or unprotected sex, driving drunk, participating in dangerous or extreme sports, engaging in self-mutilation, or signing up for the armed forces on a lark . . . these are all examples of ways to cope with the feelings that you’re barely alive and that there’s nothing left inside you. At this stage of burnout, you may avoid leisure time because the sense of emptiness is so intense that it’s just too painful to be in your own company.
Foods that you once enjoyed may seem flat or uninteresting. A salad, for example, may seem too bland to pique your appetite. But (even if you’ve been a health-food aficionado) a quart of ice cream, four pieces of fudge, or an entire rack of ribs may temporarily bring you back to life. Powerful, pleasing tastes may bridge the gap between you and sensation far more easily than a plate of steamed vegetables or a poached egg on dry toast.
I ate a lot of bacon (so sorry, arteries) when I was burned out despite the fact that I’d once spent years as a vegetarian and generally eat a healthy diet. Fortunately, you can recover your balance by making nutritional choices that will actually help you feel better.
Self-Reflection Exercise #10: What Foods Make You Feel Good?
It’s hard to give up behaviors that feel good (even if they’re harmful) for ones that feel less rewarding (even if they’re beneficial). When my husband and I interviewed the Hindu scholar Swami Adiswarananda for our book Your Soul’s Compass, he made an important point: None of us renounces what feels good for something that feels worse, but we will happily renounce what we’ve been doing for something that feels better. The point of this exercise is to find the something that feels better.
Keep track of your food and mood in a very simple way for one week. Stick with your usual diet and, using a scale of 1 to 10 (where 1 is the worst and 10 is the best), rate your overall sense of well-being.
Then at the start of the following week, make one healthy change to your diet—whatever is easiest and most sensible for you. It might be eating breakfast if you don’t already do so. Maybe it’s enjoying a fresh salad for lunch every day. Or how about making sure you’re eating five servings of fruit and vegetables daily? At week’s end, check out your level of well-being on the 10-point scale.
Was there any difference between the two weeks? If not, try another simple dietary experiment. Sooner or later, you’ll be able to renounce what isn’t working for something that feels better. A positive side effect of your experiment is that it engages you in the practice of self-care, which is vital to reviving from burnout.
Stage 11: Who Cares and Why Bother?
People who are burned out and hardly give a damn about anything look and feel depressed. But are depression and burnout really the same thing? This is an important question since depressed people are often given powerful drugs with substantial side effects. Do antidepressants work when we’re fried? And even if they revive us in the short run, can they help us mend our lives?
Several research teams have asked this question and labored to find some distinction between burnout and depression that’s relevant to people’s lives rather than just an academic exercise in splitting hairs. Emotional exhaustion is the most salient symptom of both burnout and depression. Fatigue, emptiness, hopelessness, indifference, apathy, and meaninglessness are also obvious overlaps.
Psychologist and burnout expert Veerle Brenninkmeijer and her colleagues at the University of Groningen in the Netherlands do make some distinctions between burnout and depression. They have observed that, compared with depressed individuals, people high in burnout:
(1) make a more vital impression and are more able to enjoy things (although they often lack the energy for it); (2) rarely lose weight, show psychomotoric inhibition (slow down) or report thoughts about suicide; (3) have more realistic feelings of guilt, if they feel guilty; (4) tend to attribute their indecisiveness and inactivity to their fatigue rather than to their illness (as depressed individuals tend to do); (5) often have difficulty falling asleep, whereas in the case of depression one tends to wake up too early.7
These distinctions may seem academic, but they make the point that depression and burnout are hard to distinguish and that medicating people for what appears to be depression—rather than helping them with the underlying traits that predispose them to burnout— may be a singular disservice.
Since one in six of us will receive a diagnosis of depression at some point in our lifetime (the reason for this, in large part, is that drug companies have a vested interest in people being diagnosed with depression so that they can be medicated, as we’ll discuss in the following chapter), we’re losing a lot of very talented human beings to burnout—a preventable and treatable disorder of the soul.
Self-Reflection Exercise #11: Do You Need Professional Help?
Depression—whether it’s related to burnout, grief and loss, overwhelming stress, or biological factors (and these, as you will read, are much rarer than Big Pharma would have you believe)—can be a crippling affliction that needs to be attended to as quickly as possible.
Most people seek help for depression from their family doctor first. Unfortunately, he or she may not be the best source of information and treatment. Most family-practice docs are pressed for time and don’t have specialty training in psychiatry. They may, however, be a good source of referral.
If you work for a company that has an EAP (Employee Assistance Program), ask for an appointment because the staff members in these departments are likely to be skilled in the assessment and treatment of burnout. If you don’t have access to an EAP, find a mental-health professional in your area who has expertise in both depression and burnout. You have to be upfront and insistent about getting this information
Your helper can be a psychiatrist, psychologist, social worker, nurse-practitioner, or other mental-health professional. Alternative therapies from bodywork to meditation may also be vital for revival, but make sure that you cover all your bases and don’t get sidetracked by an alternative or mainstream professional who is a one-trick pony, quickly prescribing antidepressants or supplements or recommending acupuncture, yoga, and so on. While any and all of these may help, none is likely to do the trick on its own.
Finding competent help can seem overwhelming when you’re depressed, so you may have to delegate this task, or at least parts of it, to a family member or friend.
Stage 12: Physical and Mental Collapse
Ellen, an international corporate consultant, was so exhausted and strung out that she fainted at the airport while waiting to board a flight to Heathrow. The paramedics—a very efficient crew, so she said—peeled her off the floor and whisked her away in an ambulance. After a trip to the ER revealed nothing more serious than borderline hypertension and exhaustion, she went home and managed to regroup overnight. The next day at 9:05 A.M., she was on a plane to London to meet up with the rest of her team. Like all burnout enthusiasts, Ellen would have felt like a total slacker if she’d taken even one more day to rest and recover.
A few months later, Ellen developed lupus, an autoimmune disease that runs in her family. Nobody can withstand the kind of punishment that she was doling out to herself. While not everyone who succumbs to burnout will develop a serious illness like Ellen did, her outcome is not at all rare. When you tell your body that you’re not particularly interested in living, and you let your life force run perilously low, it’s not surprising that the physical plant obliges by shutting down.
Like Ellen, some of us will keep on keeping on until our health gives out. And trust me—it will Approximately 70 to 90 percent of visits to family-practice doctors are for problems caused or made worse by stress. And burnout is a source of unrelenting stress and can exacerbate illnesses such as diabetes, cancer, or arthritis. It can also result in allergies, chronic-pain syndromes, immune disorders, digestive problems, anxiety, and depression, among other maladies.
How is it that we can let our life run out like grains of sand from an hourglass and hardly notice that we are nearly gone?
In Dante’s Divine Comedy, the Inferno is where we come to understand how we got lost in the dark woods of our own life. One of the routes is through acedia, a Greek word often associated with the word sloth or feelings of apathy and listlessness, but it’s really a kind of “spiritual dryness.” In the Middle Ages, it often afflicted clerics who were overcome by the sorrow and suffering they encountered. They lost their connection to Spirit and gave up hope. But you don’t have to be a member of the clergy to lose touch with the magic and aliveness of the world.
FBF Beverly Potter described the feeling in this way:
It’s a spiritual crisis—a life or death choice. If choosing life, one must somehow dig deep down to find something to grasp and enhance into a revitalizing life force. Certainly those caught up in burnout’s vicious cycle (as I call it) hardly remember aliveness. They are dragging. They are depressed, dispirited, unmotivated, despairing . . . they are down—shutting down and giving up.
In order to come through such a dry period, we need to find some seeds of renewal—something to grasp and enhance into a revitalizing life force, as Beverly so eloquently put it.
Self-Reflection Exercise #12: Choosing Life
Here is another 30-minute writing exercise to try: write about what means the most to you and how to bring more of it into your life. When I did this, the first thing that came up was spending more time with family—my husband and our children and grandchildren. I travel so much that it’s hard to schedule seeing the kids and their families (they all live at a distance), and I’m so tired that the thought of getting on a plane again seems punishing. The answer? We are considering acquiring an RV and driving it around visiting family from March through mid-May, which is “mud season” (the only truly depressing time of year) at home in the mountains of Colorado. The thought of picking up the Phoenix grandkids and driving them to see the California clan revives me. Even doing the research on the various types of RVs is fun and reviving.
The choice to be generative and create a new life or to wither on the vine is yours alone. My hope is that learning more about why particular people burn out and what revives them—which we will continue to discuss in the following chapters—will help you understand your own feelings better and make it easier for you to choose life rather than to give in to hopelessness or depression.
