By: Melissa Barlock
Where the concept of "burnout" came from..
Burnout as a concept has been gaining traction in the media in recent years, most likely primarily due to modernization and increasing awareness of the associated consequences to mental health and well-being. Further disruption and uncertainty due to the ongoing COVID-19 pandemic has accelerated this concern and placed mental health in the spotlight.
Burnout conjures up images of a once lively flame fizzling out. Tell someone you’ve been working a lot lately and you’re burned out, and they won’t question what you mean; there isn’t much ambiguity. They’ll understand that, due to excessive demands on your time and energy, you are mentally and/or physically exhausted.
We’ve all been there. The term has been circulating among the public for quite some time, but its exact origins are unclear. Credit is often given to Dr. Herbert J. Freudenberger, a German-born American psychologist who published an article entitled Staff Burn-Out in the Journal of Social Issues in 1974 (1). In it he describes his own personal experience with burnout and subsequent analysis while working overtime at a free clinic for substance abusers in New York City. Using a definition attained from a dictionary (unreferenced), he described burnout as ‘‘to fail, wear out, or become exhausted by making excessive demand on energy, strength, or resources.’’ He then goes on to describe physical, behavioural, and psychological signs of burnout, and then makes a conjecture as to who is prone to burnout, followed by some suggestions for preventative measures and how to help someone who has burned out (1).
Following Freudenberger came Dr. Christina Maslach, Assistant Professor of Psychology at the University of California, Berkeley (2). Her first article on burnout was published in 1976. A pioneer and one of the most distinguished researchers in the field, she has since written numerous articles and books on the subject, and you can see her in various videos online. Maslach indicates that “Burnout is a prolonged response to chronic emotional and interpersonal stressors on the job, and is defined by the three dimensions of exhaustion, cynicism, and inefficacy” (3). She is perhaps best well known for creating and refining, along with her colleague Susan E. Jackson, the Maslach Burnout Inventory (MBI), an empirically validated and frequently used tool for assessing burnout. Along with Michael P. Leiter, Maslach is also known for creating the Areas of Worklife Scale (AWS), a tool for assessing organizational life and the employee’s relationship with their work (4). Together, these tools can be used to identify sources of burnout and aid interventions for promoting work engagement, the positive antithesis to burnout.
The World Health Organization (WHO), in the current (11th) version of the International Classification of Diseases (ICD-11), does not currently classify burnout as a medical condition, though they do recognize it as a mental health concern and acknowledge that they are working on the development of evidence-based guidelines on mental well-being in the workplace (5).
They define it as follows:
“Burn-out is a syndrome conceptualized as resulting from chronic workplace stress that has not been successfully managed. It is characterized by three dimensions:
- feelings of energy depletion or exhaustion;
- increased mental distance from one’s job, or feelings of negativism or cynicism related to one's job; and
- reduced professional efficacy” (5).
Similarly, the American Psychiatric Association (APA), in the current (5th) version of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), also does not define burnout as a psychiatric diagnosis, though some psychiatrists argue that it is a work-related stress disorder that can be classified under mental adjustment disorders (6).
It is important to note that, though burnout is currently not an official diagnosis according to the WHO or APA, that does not invalidate it as a very real problem with very real consequences; we have all felt it, even if we did not know exactly what to call it. In fact, in some countries, such a Sweden, it is a legitimate diagnosis and is already embedded in various levels of policy (2). Throughout history, it is not uncommon for attitudes to change as new evidence and understanding comes to light, and burnout is no exception. In short, burnout is the story of the medicalization and legitimization of a concept, from the “language of the people” and “pop psychology” (3), to a phenomenon worthy of serious investigation, especially in the modern era.
In upcoming articles I will more fully explore burnout, including a breakdown of its components, and address why it is important to the individual and the organization, and what can be done about it.
References
- Freudenberger HJ. Staff burn‐out. Journal of social issues. 1974 Jan;30(1):159-65.
- Friberg T. Burnout: from popular culture to psychiatric diagnosis in Sweden. Culture, Medicine, and Psychiatry. 2009 Dec;33(4):538-58.
- Maslach C, Schaufeli WB, Leiter MP. Job burnout. Annual review of psychology. 2001 Feb;52(1):397-422.
- Leiter MP, Maslach C. Areas of worklife: A structured approach to organizational predictors of job burnout. InEmotional and physiological processes and positive intervention strategies 2003 Dec 17. Emerald Group Publishing Limited.
- Burn-out an "occupational phenomenon": International Classification of Diseases [Internet]. 2019 May 28 [cited 2021 May 24]. Available from: https://www.who.int/news/item/28-05-2019-burn-out-an-occupational-phenomenon-international-classification-of-diseases.
- Chirico F. Adjustment Disorders in DSM-5: implications for occupational health surveillance. Acta Psychopathologica. 2015;1(14).
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