We live in interesting times. The covid-19 pandemic, increasing social and economical inequalities, ecological and social crisis. As a psychotherapist in central London, I have been dealing with these topics in the consulting room and it seems that existential questions linked to the socio-political atmosphere are more present than ever.

This article is about burnout and its numerous manifestations, however, I will argue that this is not an isolated individual difficulty but is deeply rooted in our social and cultural environment.

Burnout as crisis

2020 has been a difficult year for many. We have experienced an unprecedented national health crisis, many have lost their loved ones, their jobs and their wellbeing has been severely affected. The pandemic is not over yet. Google search data reveals further mental health crisis, as the prediction, based on this year’s 24% increase in online searches about the meaning of burnout and its symptoms, is dangerously manifesting. How do we orient ourselves in these difficult times and with the proliferation of information? How do we think about concepts such as burnout?

For the purposes of this post, I will not be outlining the clinical, diagnostic system for identifying the symptoms of burnout, as I believe that we are all different and experience difficulties in our unique way. What I will attempt instead, is a broader picture of what burnout might mean on a psychological and emotional level and how we can help ourselves and seek appropriate professional support before the symptoms of burnout become too entrenched in our lives. 

From my experience as a psychotherapist, working with individuals from the most diverse environments and backgrounds, dealing with personal and work-related difficulties, I started to look for patterns and similarities. Instead of focusing on the symptoms, I asked myself what are these symptoms a manifestation of? One way of looking at burnout is in terms of a crisis, a conflict between parts of ourselves. The inner or internal crisis might be a manifestation of the outer world, or alternatively, our psyche can be in a conflict with the external world and its predominant values.

As I stressed before, the experience of burnout or crisis is far from a personal or individual problem, it is deeply interdependent with the environment that the person inhabits. In line with the feminist tenet and political movement from the late 1960s “the personal is political”, I believe that question of mental health is social and political. 

We live in a society where the notion of what is personal and individual is dangerously divided from the wider social-cultural environment. This creates a culture of blame, situating the problem within an individual, divorcing all responsibility from the wider cultural space. It also creates fear of being excluded and seen as weak, which prevents us from speaking out and mobilising movements of counter power. 

Peters story

I would like you to imagine this scenario, a story that too often happens to people every day.

Peter, a 35-year-old man, has been working for a big advertisement firm for a number of years, he has been progressing in his career, and his life was seemingly going in the right direction. He dedicated most of his time and energy to his work obligations because the corporate culture expected this from him, but equally, Peter shared the same work ethic. His father was a hard-working man himself and he always reminded Peter he needed to work hard if he wanted to get ahead in life. 

One day Peter’s boss called him into his office and offered him a promotion. Peter was thrilled as this was just another validation of his efforts — his hard work had finally paid off. Eventually, it became apparent that he had been working hard in order to work even harder. The promotion came with additional responsibilities and longer hours. Peter became more disengaged, he suffered from fatigue and increasingly low moods. When he noticed these difficult feelings and sensations arising, he would work even harder or go to the gym to distract himself.

At this point, Peter hardly got any sleep. To make matters even worse, two of his colleagues at work were dismissed as their roles dissolved, and Peter had to take up their responsibilities as well. Peter started to experience severe anxiety as a response to the pressure at work and he started dreading going to the office. He knew that he needed to speak to his boss but feared that he would not understand and just replace him with someone that was willing to keep up with the ever-increasing demands of the firm. Eventually, Peter’s performance started to decline, he was unable to concentrate, started to make mistakes, which resulted in a deep sense of failure. His body weakened and soon after he was hospitalised due to severe work-related stress and exhaustion. 

The story of Peter is not an isolated case and many people experience symptoms of burnout to some degree, every day. One of the reasons for this profound emotional pain lies in our alienation from our basic instincts and our lost knowledge of the self. Peter’s body started to communicate very early on that things were not going in the right direction, meaning things were starting to move further away from the self. He chose to ignore the deeper knowledge of his body and continued to follow the ambitions of his ego.

There are numerous reasons why this happens. Perhaps we fear being seen as ‘quitters’ or we are worried what others might think about our instinctive needs. Often there is also a profound fear of losing the familiar. These fears have a contextual grounding. I believe that our society is complicit in generating these fears by isolating and locating distress within the individual. If Peter’s organisation invited dialogue, showed empathy and care, he might have felt empowered to speak up about his difficulties and find adequate support sooner.

The opportunity 

The crisis that we see at different stages of burnout correspond to different stages of alienation from our deeper knowledge of the self. We can view this as a channel of communication between the ego and other parts of the self. According to Freud, ego is the mechanism that negotiates and abides by the reality principle, which keeps our desires realistic and socially appropriate. But often other parts of the self are severed and silenced at the expense of our true (self) desires, because the ego monopolises the psychic’s economy. And the more this channel between ego and the other parts is blocked or severed, the more the ego reigns supreme.

Humans experience organic responses to the vicissitudes of life; we know instinctive and physiologically when our needs are not being met. Our psyche knows when something needs attention, it knows when one of our core values has been de-valued. The more our lives are guided by shoulds, oughts and musts, the further away we move from that deeper knowledge and connection to the self. 

But my belief is that not all is lost. In fact there is hope, because in every crisis there is also an opportunity. If we can see the crisis as a signal and a call to change, we create a space of potential, where the crisis is transformed into a higher level of awareness. This process implies a certain loss and acceptance that you or some of your values might be changing. Every change opens us to the radical and inherent insecurity of life, the space of not knowing.

What will happen next, and where am I going? These existential questions can be profoundly unsettling or experienced as a betrayal of what and who we used to be. But paradoxically, what we can experience as burnout is really the result of neglect and betrayal of the self. To illustrate this principle, I will use a clinical example of the work I have done with Mary. Some details of the clinical material are altered to protect the client’s identity.

Marys story

Mary came to see me at a particular point in her life. She was in the second half of her life, with a successful career and her children were already living independent lives. She was divorced and never re-married. She complained about the lack of meaning and growing sense of dissatisfaction. She felt that her life was over and that there was not much to look forward to. It was clear to me that Mary was experiencing a loss of self, the guiding principle in her psyche was weakening and dying. I was wondering what would bring the much-needed renewal of the energy. I tried to engage her imagination in different ways, asking her about her favourite movies, books and activities, but all of my efforts were of little to no avail. She was unwilling to let go of the image she had of herself, not ready to acknowledge the loss of her role as a mother and a successful businesswoman. 

One day Mary reported a dream that she had. She described the scene as following: She is standing in a desert. She has no sense of orientation and she feels increasingly agitated. There is no water. She finds a well but it is all dried up. She fears for her life, decides she needs to walk further. In the distance she notices something, a child. She tries to reach her, but she keeps on moving further and further away. She wakes up in tears. 

As Mary was speaking about her dream I noticed a deep sense of sadness and that her dream was filled with symbolic meaning. When we explored the dream and how she felt about it, she spoke about a deep sense of fear and abandonment. She recalled a painful memory from her childhood when she was sent to boarding school at the age of 5. I knew then that we had found a connection to her deeper self. This communication from her unconscious in the form of a dream was the opportunity, a space of loss that needed addressing. Mary went through a prolonged period of grief and started to work through some of the difficult emotions connected to her early childhood trauma. 

Conclusion

“Weiji” a Chinese word for what we in the West might interpret as crisis is composed of two characters signifying danger” (wēi, ) and changepoint” (jī, ).

Burnout or experience of crisis can affect us at different points in our lives and impact different areas. It can be triggered by work situations, family and relational difficulties or through individual experiences. The two stories above illustrate very different outcomes to the same basic, contemporary human experience; the loss of self. Perhaps we have entered into a wider crisis within the western culture, which needs changing.

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