What You Might Not Realize About Burnout

Burnout is so much more than just fatigue.

(This article contains a fictional vignette. It is a composite case study using pseudonyms and a compilation of issues that come up frequently in my professional work. This is a common writing technique for practicing psychologists and is a way of discussing therapeutic techniques and outcomes while protecting patient confidentiality and dignity.)

My work as a clinical psychologist grants me a unique vantage point for understanding burnout.

The prevalence of burnout is astronomical, higher than 50% in some professions. So chances are you’ve experienced it at some point in your life. It’s one of those things where you know it when it hits you.

It’s not the same as stress. And it’s not the same as depression, anxiety, or panic- though all those things may be included.

And burnout is so much more than simple fatigue.

Burnout is a rot.

The psychologist Christina Maslach provides us with a helpful formulation:

It’s depersonalization (feeling like a nameless cog in a machine). It’s stagnation (feeling like you’re spinning your wheels but not getting any results). It’s a fatigue that paralyzes your body, brain, and emotions.

But there’s another aspect of burnout that people sometimes don’t realize is there, or they may find it difficult to articulate. It’s a belief about the world that simply isn’t true - that nobody sees what you’re going through.

(The following is a fictional vignette/composite case study.)

Tom is an administrator overseeing multiple clinics in small rural communities. He came to see me when the pandemic was at its worst. He was working about 80 hours a week and had a front row seat to the public health nightmare.

I’m sure you remember the stories. Hospitals were overflowing. People were sent home to die alone unless somebody else died earlier that day leaving a vacancy in the facility. While most of us were hearing about this on the evening news, Tom was the one making the difficult decisions and delivering the news to desperate patients day after day.

He watched the tragedy unfold for months with no rest.

The week I met him, he had just watched one of his employees, a healthy 32-year old doctor, die after contracting the virus.

On top of that, Tom’s marriage was going through a rough spot. Conversations with his wife seemed to always turn into conflict. Especially if it included any attempts to open up about what was bothering him.

You’d have to meet Tom to understand. He is a big guy- about 6-3 or 6-4. And fit. He’s not the kind of person- as the worn out cliché goes- that you would want to have angry at you. (The implication being that anger is the inevitable prelude to physical violence.) And that was a big part of his story. People found him intimidating. Any ounce of displeasure, concern, or frustration was interpreted by people around him as anger. And anger as a threat. And it scared them.

So Tom learned to wear a mask.

He learned to hide the most important part of himself, the part that responded with anger to violations of his value of caring for others.

When I met him for the first time, it had gotten to the point where he had considered taking his own life. And that scared him.

Tom met all the criteria for burnout- and then some. Depersonalization. Stagnation. Fatigue. But the critical point for him was the feeling that no one in his sphere saw him as a person. Only a collection of social roles. An authority figure on a pedestal. Or a tyrant to depose. But not a person with needs of his own.

One of the turning points in our work together came through a simple exercise. I started a sentence and asked Tom to fill in the blank:

What I would like to hear from other people is…

“I can see that you’re doing your best.”

Tom was in tears as he said it.

That was the breaking point for him and for so many of the clients I work with- knowing that other people see that you are doing your best. And allowing your best to be enough.

That’s the thing that a lot of people don’t realize about burnout. Underneath the symptoms is the learned belief that they have become invisible in their own life story.

Want to learn more about where things go from there? Sign up for my free newsletter to get next week’s article on Advanced Stress Management which describes how to leverage individual therapy to affect change at a multi-person level and dismantle the conditions that allow burnout to happen in the first place.

As always, you can reach out by email to set up a free consultation if you or someone you know is experiencing burnout.

-Austin