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.