How can we prevent the growing risk of burnout at work ?

Dere­lic­tion is a fee­ling of extreme aban­don­ment in which a per­son feels neglec­ted by eve­ryone and neglects him or her­self, to the point of no lon­ger “bothe­ring”. This dis­tur­bance of conscious­ness is the result of trau­ma­tic events, pro­lon­ged per­iods of stress or situa­tions of great uncer­tain­ty and per­plexi­ty, such as those expe­rien­ced during the pan­de­mic¹. The conse­quences are many and vary from one indi­vi­dual to ano­ther, both psy­cho­lo­gi­cal­ly (loss of dis­cern­ment and deci­sion-making capa­ci­ty, exhaus­tion, depres­sion, anxie­ty, loss of sleep, etc.) and phy­sio­lo­gi­cal­ly (hyper­ten­sion, heart disease, dia­betes, wea­ke­ned immune defences), and can lead to com­pen­sa­to­ry beha­viour desi­gned to cope, but in an inap­pro­priate way (addic­tions, crys­tal­li­sa­tion of thought, adhe­rence to sim­pli­fying schemes, emo­tio­nal dra­ma­ti­sa­tion or mobi­li­sa­tion of fan­ta­si­sed inter­pre­ta­tions such as conspi­ra­cy theo­ries²³.

In a pro­fes­sio­nal context, the concept of exhaus­tion syn­dromes – or bur­nout – is used to des­cribe the psy­cho­lo­gi­cal and beha­viou­ral ero­sion of the indi­vi­dual. It is dif­fi­cult to quan­ti­fy bur­nout, and the epi­de­mio­lo­gi­cal data is incon­sistent. The most accu­rate data is asses­sed by pro­fes­sion and is stri­king in its den­si­ty. For example, in 2019, E. Gre­bot⁴ lists the bur­nout figures in France for doc­tors (10%), emer­gen­cy phy­si­cians (51%) and school­tea­chers (16%). Since 2010, there has been a rapid increase in the fre­quen­cy of work-rela­ted men­tal ill­ness⁵. The num­ber of reco­gni­sed psy­cho­lo­gi­cal occu­pa­tio­nal ill­nesses increa­sed seven­fold bet­ween 2012 and 2016, from 82 to 563⁶. The public bodies that rely on sur­veillance pro­grammes via occu­pa­tio­nal phy­si­cians (San­té Publique France, DREETS) note that work-rela­ted men­tal health pro­blems are now a major public health issue, even more so because of the social imba­lances : in 2019, women (5.9%) were twice as like­ly to be affec­ted as men (2.7%). These figures dou­bled bet­ween 2007 and 2019⁷, and the most fre­quent­ly repor­ted condi­tions are anxie­ty and depres­sive disorders.

Bur­nout pre­ven­tion methods are based on work orga­ni­sa­tion and pro­fes­sio­nal rela­tions. These are now well docu­men­ted thanks to tech­niques for ana­ly­sing actual work situa­tions (iden­ti­fi­ca­tion of psy­cho­so­cial risk fac­tors – PSRs) and the action plans to fol­low⁸. These pre­ven­tive actions focus on work situa­tions, based on six major risk fami­lies⁹ :

1. Work inten­si­ty (e.g. the accu­mu­la­tion of contra­dic­to­ry demands with unrea­lis­tic objectives),
2. Emo­tio­nal demands (e.g. recur­rent expo­sure to guilt-trip­ping and aggressivity),
3. Auto­no­my (e.g. total lack of choice in how to achieve set objectives),
4. Qua­li­ty of social rela­tions (e.g. fin­ding one­self in the posi­tion of a “sca­pe­goat”),
5. Conflict of values (e.g. having to do things of which you disap­prove moral­ly) and
6. Job inse­cu­ri­ty (e.g. being convin­ced that you won’t be able to conti­nue your arduous job until you are 60, while having no pos­si­bi­li­ty for making a change).

Com­pa­nies are mobi­li­sed to prevent PSRs via the Employee Health and Safe­ty Com­mit­tee (or PSR com­mit­tees if they have been set up), using tools that enable these risks to be mea­su­red objec­ti­ve­ly¹⁰. The fact remains that, des­pite pre­ven­tive action, PSRs conti­nues to recur, with nega­tive conse­quences for employees and companies.

A num­ber of methods have emer­ged in recent years to deal with work-rela­ted psy­cho­lo­gi­cal suf­fe­ring, with the aim of hel­ping people to show resi­lience, chan­nel their stress, regu­late their emo­tions or cope with intense pres­sure. Examples include mind­ful­ness medi­ta­tion pro­grammes, relaxa­tion and mas­sage work­shops, trai­ning in time mana­ge­ment and per­so­nal orga­ni­sa­tion, stress and ener­gy mana­ge­ment work­shops, well­being coa­ching appli­ca­tions, and methods for get­ting a bet­ter night’s sleep des­pite a dif­fi­cult envi­ron­ment : all of these methods have the cha­rac­te­ris­tic of being cen­tred on the indi­vi­dual and not on his or her envi­ron­ment. The aim of these approaches is to change the per­son, not the nega­tive work situa­tion. Stu­dies show that the best way to improve employees’ well-being is to act on their envi­ron­ment rather than tar­ge­ting indi­vi­duals’ resi­lience¹¹¹².

Well-being methods, which are now wide­ly pro­mo­ted, may well be appre­cia­ted by their bene­fi­cia­ries, but are they effec­tive ? Do they have limi­ta­tions, or even nega­tive effects ? These ques­tions are rare­ly asked, given the assump­tion that a well-being method will result in well-being ! What’s more, it’s not easy to mea­sure their effects objec­ti­ve­ly. Do these methods pro­vide suf­fi­cient resources to balance the demands of the job ? Resear­chers are begin­ning to ask these ques­tions, with some start­ling results. The latest large-scale stu­dy on this sub­ject¹³ invol­ved 46,336 UK employees in 233 com­pa­nies and asses­sed the impact of 12 men­tal health well­being methods : mind­ful­ness trai­ning to cope bet­ter with pres­sure, relaxa­tion to reco­ver more qui­ck­ly, time mana­ge­ment to cope bet­ter with men­tal work­load, sleep mana­ge­ment to main­tain concen­tra­tion, online coa­ching or smart­phone well­being appli­ca­tions to be resi­lient, etc… In this stu­dy, employees who bene­fi­ted from these men­tal health pro­grammes, as well as those who did not, were asked to des­cribe, at dif­ferent points in time, their per­so­nal per­cep­tions of their men­tal well-being (based on health psy­cho­lo­gy appro­ved scales), their pro­fes­sio­nal com­mit­ment and bur­nout, social rela­tions in the com­pa­ny and the work environment.

What do the results show ? First­ly, that there was no signi­fi­cant dif­fe­rence in men­tal health bet­ween employees who bene­fi­ted from the pro­grammes and those who did not. The results even show some nega­tive effects on the bene­fi­cia­ries, for example in the case of stress mana­ge­ment pro­grammes. The resear­chers hypo­the­sise that making the indi­vi­dual res­pon­sible for mana­ging a dete­rio­ra­ting situa­tion through bet­ter stress mana­ge­ment accen­tuates the idea that the pro­blem lies with the indi­vi­dual and the­re­fore rein­forces the fee­ling of powerlessness.

Nor do we find any posi­tive effects of these pro­grammes on team col­la­bo­ra­tion. If the sample is bro­ken down by type of busi­ness, the results conti­nue to show that men­tal well-being pro­grammes are not effec­tive. Recent stu­dies point to the same conclu­sion for dif­ferent coun­tries in Europe¹⁴ and the USA¹⁵¹⁶.

On the other hand, these stu­dies show that if some of these well-being prac­tices are com­bi­ned with struc­tu­ral changes in work orga­ni­sa­tion and indus­trial rela­tions, then the effects start to be beneficial.

So, the ques­tion arises : how can indi­vi­duals and orga­ni­sa­tions work toge­ther to deve­lop, des­pite the inherent dif­fi­cul­ties ? How can employees them­selves be pro­mo­ters of orga­ni­sa­tio­nal change, able to iden­ti­fy and contri­bute to the cor­rec­tion of dete­rio­ra­ting situa­tions, without having to bear the conse­quences that are beyond their control ? This pers­pec­tive implies moving away from sim­plis­tic schemes and reac­tive “pro­blem-solu­tion” pos­tures in which employees are offe­red psy­cho­lo­gi­cal well-being pro­grammes to help them manage per­iods of stress and remain effi­cient des­pite situa­tions that have signi­fi­cant­ly dete­rio­ra­ted. The chal­lenge is to pro­vide them with genuine “Psy­cho­so­cial Resources¹⁷” (PSR) before pro­blems arise. These resources should be concei­ved as “psy­cho­lo­gi­cal capi­tal”, in the same way as “finan­cial capi­tal” or “social capi­tal”, i.e. a reserve that enables people to “look ahead”, to anti­ci­pate, rec­ti­fy or even avoid difficulties.

Psy­Cap, or psy­cho­lo­gi­cal capi­tal, is a concept deve­lo­ped in the ear­ly 2000s by two Ame­ri­can mana­ge­ment resear­chers, Fred Luthans and Caro­lyn Yous­sef¹⁸. For 20 years now, this model has been tes­ted, cor­rec­ted and enri­ched by resear­chers, with results that are now sound enough to allow it to be dis­se­mi­na­ted¹⁹. It can be seen as a “men­tal resi­lience²⁰” that deve­lops, trains and enriches. These are not stable per­so­na­li­ty traits but shif­ting men­tal states.

There are four PsyCap ingredients :

#1 Self-effi­ca­cy is a belief in one’s own abi­li­ty to draw on resources to com­plete a task. For example, a team lea­der is given a new tech­ni­cal assi­gn­ment for which they do not yet have much expe­rience. Rather than doub­ting them­selves, they can use their abi­li­ty to learn qui­ck­ly and adapt. This pre­sup­poses that they have a clear sense of them­selves and have taken stock of their skills, so that they aren’t thrown in at the deep end. Kno­wing your strengths and weak­nesses is an impor­tant part of buil­ding self-confidence.

#2 Hope is the abi­li­ty to per­se­vere and find solu­tions des­pite set­backs, kno­wing that the result can be achie­ved. For example, Camille works for a com­pa­ny that is under­going a major reor­ga­ni­sa­tion, and the future of her job is uncer­tain. Without allo­wing her­self to be overw­hel­med by stress, she drew up a rea­lis­tic road­map to enhance her skills, iden­ti­fy oppor­tu­ni­ties and plan ahead. Unlike hope that stems from a gene­ral idea­li­sed dis­po­si­tion, here hope is goal-orien­ted, a “pas­sion for the pos­sible”, a force for action that pro­vides the neces­sa­ry resources, inclu­ding the abi­li­ty to alter course when neces­sa­ry. Hope is the­re­fore as much about the will to achieve a goal as it is about the path to get­ting there.

#3 Opti­mism is the abi­li­ty to take owner­ship of one’s present or future suc­cess. This means being aware of the effects of your deci­sions and actions through regu­lar, objec­tive feed­back. For example, a tea­cher works with pupils who are fai­ling and remains convin­ced of their abi­li­ty to improve : he intro­duces new tech­niques, adapts his pro­gramme and shows them their abi­li­ty to pro­gress. Without it, the loss of mea­ning gene­rates pes­si­mism and accen­tuates the fac­tors that lead to dere­lic­tion : an increase in fai­lures, a decrease in suc­cesses, gene­ra­li­sa­tion of pro­blem situa­tions, a focus on details at the expense of what is most essen­tial, and dicho­to­mous thin­king²¹. Opti­mism must, of course, be based on objec­ti­ve­ly veri­fiable facts if it is not to des­cend into blind unrea­lism. Faced with set­backs, the rea­lis­tic opti­mist takes stock, learns, and looks to the long term.

Psy­Cap enables indi­vi­duals not to be foo­led by the dif­fi­cul­ties they may encoun­ter, to anti­ci­pate and spot them, then adjust their behaviour.

#4 Resi­lience consists of put­ting in place posi­tive pat­terns of adap­ta­tion, both in the face of adver­si­ty or risks and in the face of posi­tive events such as an increase in res­pon­si­bi­li­ties. Rather than avoi­ding dif­fi­cul­ties (by denial, for example), resi­lience involves reco­gni­sing their rea­li­ty. For example, a baker who is pas­sio­nate about their job deve­lops an aller­gy to flour. They need to take stock of their pro­fes­sio­nal skills in order to find a new job that res­pects what they “like to do” and not just what they “know how to do”.

Nume­rous inter­na­tio­nal stu­dies show a cau­sal link bet­ween Psy­Cap and psy­cho­lo­gi­cal health : stress, bur­nout, depres­sion, fatigue²². Psy­Cap enables indi­vi­duals not to be foo­led by the dif­fi­cul­ties they may encoun­ter, to anti­ci­pate and spot them, then adjust their beha­viour, know how to say yes or no at the right moment, and not have to bear res­pon­si­bi­li­ties that are not theirs to bear.

Although the four com­po­nents of Psy­Cap have been iden­ti­fied sepa­ra­te­ly in the scien­ti­fic lite­ra­ture, they enhance each other. Deve­lop­ment pro­grammes are orga­ni­sed around a num­ber of major themes which are rele­vant in both the pro­fes­sio­nal and pri­vate spheres²³ :

#1 Regu­lar feed­back prac­tice to help indi­vi­duals make the link bet­ween their skills, their beha­viours and the conse­quences of those beha­viours. The aim is to create posi­tive rein­for­ce­ment and mea­ning, to inter­na­lise the fee­ling of self-effi­ca­cy. Of course, feed­back can be posi­tive or nega­tive, but the chal­lenge is to clear­ly explain the right indi­ca­tors and mea­sure pro­gress step by step to avoid anger or shame. In a pro­fes­sio­nal context, the method consists of sepa­ra­ting nega­tive feed­back, which focuses on the work pro­cess (the way the work is done) from posi­tive feed­back, which focuses on results and deve­lop­ment (the pro­duct of the work and the individual’s poten­tial²⁴).

#2 Car­ry out assess­ments of past expe­riences (posi­tive or nega­tive) to deve­lop self-know­ledge and thus objec­ti­fy the resources that can be drawn on in the future. These reviews can take the form of expe­rience feed­back, as is done in indus­try (REX, RETEX), but also in the form of expla­na­to­ry inter­views²⁵ with the aim of trans­fer­ring suc­cesses from one situa­tion to ano­ther, and thus increa­sing resi­lience resources by mas­te­ring know-how.

#3 Ino­cu­late your­self against fai­lure : like a vac­cine against viruses, it is pos­sible to streng­then resi­lience in the face of nega­tive events by esta­bli­shing a “fai­lure metho­do­lo­gy”. The psy­cho­lo­gi­cal ino­cu­la­tion method has been tried and tes­ted for many years to com­bat the truisms (e.g. pre­ju­dices, rou­tines or habits) that get in the way of our jud­ge­ments and deci­sions. An ino­cu­la­tion work­shop takes place in two stages : first car­rying out a “reverse brains­torm”, for example set­ting up a pre­cise stra­te­gy to increase an iden­ti­fied risk (with the aim of revea­ling the flaws in a sys­tem), and then deter­mi­ning the best res­ponses to prevent this from hap­pe­ning. It’s an excellent way of increa­sing both self-effi­ca­cy and opti­mism. This method is wide­ly used today, for example, to com­bat the havoc wrea­ked by mis­in­for­ma­tion²⁶.

#4 Learn to iden­ti­fy inter­me­diate objec­tives when we set our­selves a long-term goal, as well as the obs­tacles that are like­ly to be encoun­te­red and, in anti­ci­pa­tion, the ways of respon­ding to them or get­ting round them. Cele­bra­ting the “small vic­to­ries” of inter­me­diate objec­tives is a way of pre­ser­ving the “HOPE” com­ponent of Psy­Cap. Trai­ning in the search for obs­tacles and how to over­come them is all the more effec­tive when done in a group : Psy­Cap also deve­lops thanks to social sup­port. In this sense, “co-deve­lop­ment” groups are an inter­es­ting res­ponse²⁷.

#5 Deve­lop social skills, and in par­ti­cu­lar asser­ti­ve­ness, a pos­ture which consists of expres­sing your posi­tive fee­lings (com­pli­ments) and nega­tive fee­lings (what dis­pleases, hurts or upsets) while res­pec­ting those of the other per­son, and without trying to hurt them. This pre­sup­poses the abi­li­ty to make one’s emo­tions expli­cit, to dis­so­ciate them from emo­tio­nal reac­tions, to know how to manage conflicts so that both par­ties are satis­fied, to express one’s needs and desires (for­mu­late a request) while consi­de­ring the needs and desires of the other per­son²⁸. It is because indi­vi­duals have not suf­fi­cient­ly mas­te­red the skill of dia­logue that they can find them­selves stuck in oppo­si­tio­nal posi­tions²⁹.

The main aim is to culti­vate psy­cho­lo­gi­cal capi­tal before pro­fes­sio­nal or per­so­nal life pro­blems arise, with the aim of enri­ching psy­cho-social resources and enabling bene­fi­cia­ries to anti­ci­pate and iden­ti­fy dif­fi­cul­ties, to avoid having to bear the res­pon­si­bi­li­ty and the effects (stress, bur­nout). The aim is to enable indi­vi­duals to act on their envi­ron­ment (pro­fes­sio­nal or per­so­nal), so that they do not have to under­go the per­so­nal reme­dia­tion pro­grammes men­tio­ned above once the dif­fi­cul­ties have accumulated.