Burnt out? Relax, we’ve been exhausted for centuries

Burnout isn't new – overworked Victorians called it ‘neurasthenia’. But today's version is different


magazine@irishtimes.com ]

“Burnout” is a concept that lies, depending on who you talk to, somewhere between a medical diagnosis and a fashionable buzzword. At times it can seem like a more socially acceptable way of saying, “I am sad about my life due to callous employers and the pressures of an inhumane capitalist system.” At other times it’s more like a humblebrag: “I am stressed because I am a hardworking overachiever. Also, my gold crown is too tight.”

To put burnout into a historical context, I read a book by the University of Kent academic Anna Katharina Schaffner called Exhaustion: A History. She started writing the book, she says, because, well, she was feeling a bit burnt-out. "I noticed there were loads and loads of media reports on burnout and how it has become a really dangerous epidemic threatening the workforce," she says. "And in these articles people make the argument that we have never been as exhausted as we are nowadays."

In fact, she discovered, “anxieties about exhaustion have been with us since the age of classical antiquity. A lot of ages thought of themselves as the most exhausted. It’s not just us. A kind of hyperbolic overestimation of one’s own exhaustion is something we share with a lot of other people in other eras. The ancient Greeks were very concerned about the waning of our energies. In the 18th century people were talking about an exhaustion epidemic. In the 19th century they thought they’d reached a pinnacle of exhaustion that they had never reached before.”

She lists some diagnoses of times past: “melancholia”, “acedia”, “neurasthenia”. “What changes,” she says, “is the way we theorise exhaustion and the narratives we tell about its causes.”

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Some historical conditions like acedia (“a theological version of melancholia”) were considered to be a result of internal moral failings. Others were thought to have an external cause. The 15th-century priest and scholar Marsilio Ficino, for example, believed that “melancholia” was related to the influence of the planet Saturn. His cures included “orphic dancing”, in which the sufferer mimicked the movement of celestial bodies (this newspaper heartily endorses this as a cure for burnout).

"Neurasthenia" will sound more familiar to contemporary readers. The 19th-century American psychologist George M Beard popularised the term. The idea behind it, says Schaffner, is that "energy reserves were limited and the environment had changed in such a dramatic way that [people were] constantly being sucked dry. Overstimulation was a big concern in the 19th century. City life was thought to be too exciting – trains, cars, electric lighting blurring the boundary between day and night so people no longer rested when the sun set. And they were also concerned with entertainment, sexual liberation and so on."

Fashionable diagnosis

Like burnout, Schaffner says, neurasthenia became a fashionable diagnosis. Recommended treatments included rest cures (particularly for women, who some felt were more susceptible to mental stress) and electroshock therapy. "It was associated with sensitivity and being artistic and creative," says Schaffner. "Darwin, Virginia Woolf, Proust, Kafka – there's an endless list of people who embraced that diagnosis."

Christina Maslach, a psychology professor at the University of California in Berkeley who devised the Maslach Burnout Inventory, first came across the term "burnout" in the 1970s. "I was doing interviews with people from human service occupations to try and understand how people who face emotional issues in the course of their work cope with those kinds of feelings," says Maslach. "Then by chance, I was at a dinner at the university and [someone said], 'in poverty law we used to call it burnout.' [it's] a grassroots, bottom-up language-of-the-people kind of thing. It was never defined by some researcher or theorist – but people responded to it."

The phrase originated with a psychologist called Herbert J Freudenberger, who worked with drug addicts in New York's East Village in the 1970s. He noticed his colleagues became drained and apathetic due to the pressures of their work and applied a word to it that had previously been used to describe drug addicts: "burnout".

Burnout has had these kinds of cycles, every 10 years people rediscover it.

"Burnout has had these kinds of cycles," says Maslach. "Every 10 years people rediscover it." She has seen the term move beyond the caring professions into the workplace more widely and she has no doubt that the phenomenon is real and significant. It involves a combination of mental and physical exhaustion, she says, coupled with "depersonalisation" and "cynicism". (Maslach, for the record, says that exhaustion is just one component of burnout and that the terms "burnout" and "exhaustion" are not synonymous). She and Michael Leiter from Deakin University in Melbourne have defined six core "mismatches" in the workplace "that are predictive of burnout a year or so later."

These mismatches are themed around the following concepts:

Workload: “When the demands are high and the resources are low.”

Control and autonomy: “How much control, choice and discretion do you have over how you do your job?” asks Maslach. “If you don’t have choices or are working at a place where it’s chaotic and it’s not clear what’s being done, that will be a big predictor of burnout later on.”

Reward: “Not so much salary and benefits but much more about recognition,” says Maslach. “Positive feedback. It doesn’t mean every time you do the job well everyone has to applaud and jump up and down, but periodically, well, you’d like to hear you did well.”

Community: “Your work relationships with the public, your colleagues, your boss, the people you supervise,” says Maslach. “If there’s a lack of trust, if there are unresolved conflicts, bullying, snarky comments, people throwing each other under the bus . . . They talk about toxic workplaces – we’re finding this more and more these days.”

Fairness: “There’s research that shows when people feel the company has been unfair in labour relationships, the quality of the work they create goes down,” says Maslach. “If there is discrimination against certain people – due to gender or ethnicity – if the people getting the extra money aren’t the ones doing the work.”

Values and ethics: “This is if you you have to do things that go against your personal values,” says Maslach. “You might be required to lie, or cheat or game the system. Some people hate having to do that. Others feel the ends justify the means.”

Workplace structures

All of these things are directly linked to workplace structures and attitudes and there’s only so much “self-care” you can do to counter them. Anna Schaffner tells me she notices a distinct difference between European and Anglo-American discussions of burnout. “In the UK the discussion is very depoliticised,” she says. “It’s about building up resistance, about becoming stronger and managing your energy levels wisely. It’s basically considered to be the responsibility of the sufferer.”

Elsewhere, she says, theorists discuss “how the working environment has become so hostile and dangerous that the state is expected to intervene. [They maintain that] recent developments in the world of work, neoliberalism, precarious working environments and new technologies have really created a hostile working environment that is evermore cognitively and emotionally demanding – leaving us chronically depleted.”

People in many workplaces are non more insecure contracts, working longer hours, working overtime without pay and doing more work with fewer resources. And they're increasingly reporting a culture of fear of saying 'no'

Maslach, who regularly advises tech companies, stresses that individualistic solutions to burnout are not sufficient. “[A lot of the responses] put it back on the shoulders of the person and say, ‘Okay, you have a problem, go fix it, take care of yourself – relaxation, meditation, exercise, more sleep, quality time with family and friends.’ There’s nothing wrong with those responses but it isn’t looking at the stressors. What is actually causing this to happen? If more and more people are saying, ‘I can’t take it, I can’t do it’’ It behoves you to say, ‘What is going on out there?’”

People in many workplaces are, she says, on more insecure contracts, working longer hours, working overtime without pay and doing more work with fewer resources. “And they’re increasingly reporting a culture of fear of saying ‘no’,” she says.

She talks about start-ups in Silicon Valley known colloquially as “burnout shops” and an employer years before who said he was glad people burned out, because then he didn’t have to go to the bother of firing them. “The job is not making any room for you to handle other things in life,” she says. “We have been seeing suicides among relatively young entrepreneurs in start-ups. There was a suicide of a young guy in his 30s and someone wrote a long blog saying, ‘Please reach out. I wish he had reached out.’ Then there was an explosion of posts back: ‘I felt like that and I reached out and was shunned.’”

Anna Schaffner says that though, as her book demonstrates, an obsession with exhaustion isn’t new, each era’s iteration – whether acedia or melancholia or neurasthenia – tells you something interesting about the anxieties of that age. “What is new with burnout is the causation narrative,” she says. “It’s very specifically about the modern-day workplace.”

Maslach is careful not to overstate the problem. It’s not as prevalent as some media reports might lead you to believe, she says, “but something is wrong here. There have been changes in a lot of workplaces which are having a lot of negative consequences for people. We’re somehow losing a sense of a common good. The vision, the goal that everybody has a good life, that you can have a family if you choose, that at the end of your life you feel like you’ve made a nice contribution but you’ve also had time to do other things . . . Somehow we’ve lost that.”

If you feel you are suffering from burnout, discuss the problem with your GP. The charity Aware (1800 80 48 48) provides support on mental health issues