The phenomenon of burnout in helping professions
Professionals who are intensely involved in helping people in need, people with low functioning and people suffering from trauma, psychological, physical pain are highly exposed to burnout. Idealistic, enthusiastic, highly motivated professionals, who have high expectations from themselves and their jobs, when confronted with harsh realities inherent in their work are at risk of being worn out. Occupational stress in general is the primary cause of burnout.
working with human trafficking is, obviously, one the most stressful experiences and therefore professionals involved in the field are particularly exposed to the risk of burnout. It is important to acknowledge this risk and see it as a result of a complex array of factors, not a problem residing in the individual’s weaknesses. No professional is immune to it.
A broad definition of burnout describes it as an internal psychological experience involving feelings, attitudes, motives and expectations, a state of exhaustion on physical, mental and emotional levels, as a result of prolonged exposure to demanding situations. The person feels a lack of energy, physical
fatigue, helplessness, hopelessness, negative self-concept and a negative attitude towards work, people and life. It is difficult to identify as it is easily overlooked for being busy or blamed on other life events.
Burnout is associated with low productivity, impairment in relationships and health problems. If not treated, it can lead to complications, such as psychosomatic diseases, substance abuse, suicide attempts.
Two years ago, when she started working in an NGO for victims of abuse, Maria was a young, enthusiastic, smart and happy professional. She was absolutely sure that her training would help her solve the problems of the innocent victims of abuse and she was eager to invest all her energy into helping those who needed her.
After the first year of work, Maria became one of the best counsellors for victims of abuse in the whole institution, and she received more and more clients. With each new person that needed her help, she struggled to find new sources of energy, so she gave up many of the social activities which she found a waste of time and invested more in her job. Her boyfriend broke the relationship with her as she was practically unavailable most of the time.
During the second year at the job, Maria became more and more agitated, short-tempered, negativist, most of the time complaining about the work, about the colleagues and life in general. She began to be more and more critical and cynical, considering that none of her co-workers are committed enough, that the salary is way too small for the huge effort that the job involves, and slowly she began to think that life has nothing to offer to her and regret even the decision to choose such a career.
What is Maria experiencing? She is an empathic, humane, highly committed human service worker, but at the same time anxious, conscientious, with a tendency to get over-involved in the clients’ problems and needs. She was from the beginning of the job prone to burnout because of her active and enthusiastic, but at the same time neurotic and extraverted personality. Maria needs assistance at the workplace in order to regain efficacy and energy for work and life.
Symptoms of burnout include:
- Behavioral level: reduced efficacy at work, absenteeism, risk taking, substance abuse, complaining, lack of creativity and enjoyment, errors in setting boundaries, hyper vigilance, loss of control, suicide and homicide thoughts
- Physical level: exhaustion, various health conditions at the level of internal organs, higher risk of infections, insomnia and other sleep disorders, muscular tension, eating disorders, hyperactivity, injuries, increased vigilance
- Interpersonal level: withdrawal from family and friends, keeping hidden agendas, feeling drawn to insecure people, relationship break-ups, overreacting to comments, difficulty in boundary setting with friends and clients, loneliness, trust issues, loss of authenticity, avoidance of close contact, inability to cope with problems, anger and mistrust
- Attitudinal level: depression, feelings of emptiness and lack of meaning, oscillations between omnipotence and incompetence, cynicism, paranoia, compulsiveness and obsessiveness, callousness, guilt, boredom, helplessness, stereotyping, depersonalisation, pessimism, grandiosity, sick humor, hypercriticism, hopelessness, loss of faith, mood swings, sense of lost balance and vulnerability
There are several stages of burnout, and it is important to identify the problem as early as possible, as the apathy, indifference and disequilibrium that it leads to usually require psychotherapeutic interven-tions and even medication.
High exposure to trauma survivors’ experiences for extended periods of time can lead to “compassion fatigue” and “vicarious traumatisation”. These phenomena occur as a result of accumulated experiences of working with people who suffer from trauma. They are not temporary, but rather tend to have a long-term effect on the psychological characteristics of the professionals facing the occupational hazardsof trauma work. Both compassion fatigue and vicarious traumatisation are major factors that lead to burnout.
The deep empathy needed to deal with situations accompanying exposure to traumatised people leads to vulnerability to intense and overwhelming feelings, profound disruptions in the belief system, assaults to hope and idealism of the enthusiastic human service worker. Over-involvement and identification with the beneficiaries is detrimental to the professional, who tends to take more and more responsibility for them, to the point that he/she might feel overwhelmed with clients’ demands, unable to set boundaries to requests, eager to find cures to all the cases or frustrated over the lack of progress.
How to identify burnout?
As the signs of burnout are not specific and easily identifiable, the problem usually remains underdiagnosed and, thus, tends to evolve towards more severe and complicated forms. Though difficult to identify, before asking for professional help you can ask yourself some self-reflection questions:
- Do you feel you are emotionally worn out by your work?
- Can you give examples of situations in which you felt depleted of energy, resources, despite the fact that you were getting enough sleep?
- Do you feel a lack of personal competence and achievement in your activity?
- Did you have periods in your activity when all you wanted was to just end that job, not matter how well?
- Did you experience the need to endlessly postpone to answer phone calls from colleagues or avoided work responsibilities because you felt you lack the energy?
- Did you feel irritated with your colleagues for small delays or infringements?
- Did you change the way you relate to the beneficiaries of your services, such that you tend to be insensitive, impersonal and cold?
If you happen to answer YES to any or more of the questions above, than you should ask for a more comprehensive, detailed assessment because you are at risk for experiencing one of the main signs of burnout: emotional exhaustion, lack of personal accomplishments and depersonalisation. You are therefore at risk!
How to safeguard against burnout
Several measures can be employed in order to safeguard against burnout. It is recommended that all organisations involved in the field of crisis management, in various fields of trauma or abuse, approach to offer their employees opportunities of self-care so that burnout can be prevented. Burnout is nowadays considered an organisational, systemic problem and not an individual one, so the work environment is very important in its prevention and management.
Individual level: participation in trainings and workshops on burnout, in order to find more effective ways of dealing with job challenges, to correct attitudes that lead to over-involvement, to learn detachment and sometimes understand own unresolved issues and conflicts that interfere with work
Organisational measures: provision of support for workers, offer support groups, consultations, have job clarity, flexibility, realistic expectations, offer stress and conflict management, thus offering a supportive environment for the employees and volunteers. Other organisational measures are: clear articulation of mission, reducing ambiguity and doubt about actions that need to be taken and establishing positive relationships between workers and also with supervisors
Support systems: both instrumental support (material assistance, achievement of concrete goals) and expressive support (sense of belonging, care). Within the social support system, the individual receives emotional support, technical support, a shared social reality, as well as challenges that the person needs in order to avoid burnout
- Wisdom circles – developing compassion, values, respect for diversity, wisdom, kindness and honoring the pain of being exposed to suffering
- Relaxation, assertiveness training
- Creating opportunities to experience flow, by making activities that are pleasant and intrinsically rewarding (creative activities, music, sports, games, religious rituals, reading, dancing, writing, driving), thus generating a high state of subjective wellbeing and happiness
- Developing courage, self-determination, perseverance, future-oriented thinking
- Enhancement of self-care, after identifying the areas in which the person lacks it (http://www. compassionstrengths.com/Self-care_Checklist.html)
- Developing effective coping strategies and increasing stress hardiness
- Self-awareness of values and implementing these values in actual activities (https://www. authentichappiness.sas.upenn.edu)
- Change in the routines
- Supervision and consultation
- Support groups, a safe place in which people can share their feelings but also learn how to manage stress and solve problems, thus building a sense of competence
- Problem solving discussion groups.
This training manual is designed to be used by those who come into contact with vulnerable migrants. It aims to promote good practice in the identification and prevention of abuse and exploitation, including human trafficking, female genital mutilation and forced labour, whilst equipping those who use it with basic training skills. The exercises are developed from the lessons learnt and experience of ECPAT trainers. It is designed to be adapted and delivered easily without the need for extensive resources.
This manual is aimed at identifying people entering or living in a country where they were not born who are vulnerable to exploitation. It is important here to define which people we are targeting through this manual. These are short definitions which are explored further throughout the manual.
Asylum Seeker is someone who is fleeing persecution and has lodged an application for protection on the basis of the Refugee Convention or Article 3 of the European Convention on Human Rights, ECHR. http://rightsinfo.org/the-rights-in-the-european-convention/
Human Trafficking is the movement or harbouring of a person, through the use of force or coercion for the purpose of exploitation, typically for work, sexual exploitation, criminal purposes or organ removal.
For the full definition, refer to: UN Protocol to prevent, suppress and punish trafficking in persons, especially women and children, 2006. https://ec.europa.eu/anti-trafficking/legislation-and-case-law-international-legislation-united-nations/united-nations-protocol-prevent_en
Internally displaced persons (IDPs) are people or groups of individuals who have been forced to leave their homes or places of habitual residence, in particular as a result of, or in order to avoid the effects of, armed conflict, situations of generalised violence, violations of human rights or natural or man-made disasters, and who have not crossed an international border.
Refugee is a person who ‘owing to a well-founded fear of being persecuted for reasons of race, religion, nationality, membership of a particular social group, or political opinion, is outside the country of his nationality, and is unable to or, owing to such fear, is unwilling to avail himself of the protection of that country.’ (Definition quoted from the 1951 Refugee Convention) http://www.unhcr.org/uk/1951-refugee-convention.html
Third Country National (TCN) refers to individuals who are in transit and/or applying for visas in countries that are not their country of origin (i.e. country of transit), in order to go to destination countries that is likewise not their country of origin.