LOOK OUT FOR EMPATHY-BASED STRESS AND BURNOUT
Look closely. You can see it in their eyes, their greying temples, and every thin-lipped grimace from behind a microphone. Our public leaders have grief written all over their faces. The burdens of high office have rarely weighed more in peacetime than in the past two years. And as we roll towards the 21st month of the Covid-19 pandemic, evermore clients are presenting to our ACT Curious clinicians with symptoms of burnout or other forms of empathy-based stress.
Compassion fatigue, secondary traumatic stress and vicarious traumatisation accumulate as part of the burden of leadership. Sometimes it leads to a ‘double exposure’ on top of the personal stress we are simultaneously experiencing. We need to mentally process and manage this stress or risk burning out. Burnout affects our family, our friends, and work colleagues too, as we lose that joie de vivre of living well and our productivity suffers.
A Common Problem
Empathy-based stress can weigh anyone down. People repeatedly exposed to the distress or trauma of others are especially susceptible. Frontline caring professionals—especially those working in medical and emergency services—face the distress of others more than most. Yet small business owners and farmers, executives and managers at any level, teachers, community volunteers, personal carers, political leaders, and of course, our parents, among many others, also carry the strain of those in our charge.
Know the Signs
Empathy-based stress presents in different ways. It accumulates over time but can strike in a flash and shock you instantly; an incident or interaction that just gets to you. A diminished ability to nurture others signals compassion fatigue. Some are afflicted by acute stress, or a stress reaction induced by the trauma of the people in their care (secondary traumatic stress). Accumulated empathy-based stress can even change our thinking about basic psychological needs for safety, trust, power, esteem, and intimacy (vicarious traumatisation).
Shame or guilt at our performance, or resentment and anger directed towards those in our charge can signal empathy-based stress. Or maybe you have a lack of interest, emotion, or drive? You may even have no insight into why you are acting or feeling differently. We keep soldiering on, but something has changed.
Burnout results from an unfortunate combination of context and personality. The World Health Organization (WHO) narrowly defines burnout as an occupational syndrome resulting from chronic workplace stress that has not been successfully managed. Yet it is clear we can experience burnout anywhere—in the workplace, at home, our caring roles, or our community and voluntary activities.
We need to know we have a problem. Leading Australian burnout researchers Gordon Parker and Gabriela Tavella (University of New South Wales) and Kerrie Eyres have developed the Sydney Burnout Measure (SBM) to screen for 34 symptoms, with a high score suggesting burnout. They identify key symptoms of burnout as:
- emotional exhaustion;
- a loss of empathy;
- impaired cognition, and
- compromised work performance.
Burnout is different to anxiety or depression, but these mental health challenges often coexist, along with insomnia. Perfectionists, or people with a negative perception of their ability to perform and control their circumstances are especially predisposed to burnout.
Stress is natural and inevitable, but we can all take care to prevent burnout by understanding our stressors and knowing ourselves.
- Set your personal boundaries, protect your time, and say no when those boundaries are crossed.
- Do the work with a professional therapist to deeply understand who you are, your life story and your current state of mental health.
- Understand your values, what is important to you, and what you want to stand for in life.
Protecting your work-life balance allows you to thrive in an uncertain and complex world, by acting in the manner and moving forward in the direction you truly value.
How can we overcome burnout and address an unsustainable burden of empathy-based stress? First, we need to recognise the problem and accept the need for change. Be aware of the stressors in your daily, weekly, and annual commitments, physical environment, and your relationships.
Build or strengthen a protective support team of your family, friends, and colleagues. Find the right mental health professional who can help you to address the problem, better understand yourself, develop options and make the required changes. Schedule time for personal reflection too.
Perfectionism is a major predictor of burnout. If you are a perfectionist, address this problem. What is holding you back? Identify your triggers for fear and shame. Try not to overburden yourself with expectation, especially the unrealistic expectations of others.
See your GP for a medical check-up as well. Addressing the physical toll of burnout is equally important.
Scan your diary. What are the costs and benefits of the way you spend your time? What drains your energy? Prioritise the necessary and important tasks and tackle them one at a time. Delegate where you can. Do some things less often and drop other activities forever. Reset clear boundaries between work and the rest of your life.
One of the biggest predictors of recovery from burnout is changing your role. Change your work role if you can. If you can’t, change your job. Although difficult, it will ultimately be the right choice for you and your family.
At home, take care of the simple things. Ensure you have a well-balanced diet, remain well-hydrated and enjoy sufficient fresh air and sunshine to give yourself a daily energy boost. Take enough daily exercise to clear your mind and strengthen your body. Simple breathing techniques and meditation can alleviate immediate stress.
Outside of your work, family and community commitments, ensure you schedule time for pleasure. Joy can be found in even the smallest of things. Don’t be afraid to try new activities until your find something that works.
Take Action, Talk to ACT Curious
A flexible workplace culture and mindful approach to living is critical for our own health and for our performance at work. An Employee Assistance Program (EAP) provided by the experienced clinicians at ACT Curious will support your organisation in developing this culture. We provide the confidential support needed by people at all levels, and match clients to the right therapist to ensure personal challenges—both at work and at home—are understood and correctly addressed.
You might just help yourself too. Helping your people to thrive will lighten your own psychological burden. We can also help you to clarify your values and move forward in your valued direction. Contact ACT Curious today, to discuss how we can support you and your organisation.
📞 03 9346 8414 (Australia Wide)
Michelle Trudgen is the Clinical Director of ACT Curious.
The content of this blog is not intended to be a substitute for professional medical advice, diagnosis or treatment.
© ACT Curious Pty Ltd, 2021.
 For contemporary reviews, see Dana C. Branson (2019). Vicarious trauma, themes in research, and terminology: A review of literature. Traumatology, 25(1), 2–10; Rachel S. Rauvola, Dulce M. Vega & Kristi N. Lavigne. (2019). Compassion fatigue, secondary traumatic stress, and vicarious traumatisation: A qualitative review and research agenda. Occupational Health Science, 3, 297–336. We adopt the term ‘empathy-based stress’ as encompassing compassion fatigue, secondary traumatic stress, vicarious traumatisation and burnout, as suggested by Rauvola et al. (2019).
The term ‘vicarious traumatisation’ is often narrowly applied to the stress felt by mental health professionals. For an important foundation study, see I. Lisa McCann & Laurie Anne Pearlman (1990). Vicarious traumatization: A framework for understanding the psychological effects of working with victims. Journal of Traumatic Stress, 3(1), 131–149.
 See World Health Organization (WHO), ‘QD85 Burnout’, International Classification of Diseases, 11th Revision (ICD-11 for Mortality and Morbidity Statistics, Version : 05/2021) (accessed 20 August 2021), which defines burnout as an occupational syndrome characterised by: (a) feelings of energy depletion or exhaustion; (b) increased mental distance from one’s job, or feelings of negativism or cynicism related to one’s job, and (c) a sense of ineffectiveness and lack of accomplishment.
We share the broader perspective of many mental health researchers and clinicians by identifying burnout as a problem arising in many contexts. On underlying issues in the relationship between work and mental illness, also see Samuel B. Harvey, Matthew Modini, Sadhbh Joyce, et al. (2017). Can work make you mentally ill? A systematic meta-review of work-related risk factors for common mental health problems. Occupational and Environmental Medicine, 74(4), 301–310.
 See Gordon Parker, Gabriela Tavella & Kerrie Eyers (2021). Burnout: A Guide to Identifying Burnout and Pathways to Recovery, Allen & Unwin: Crows Nest, NSW.