Shaken Self-Trust at the Start of Burnout

The degree to which we trust ourselves is an important part of our capacity to resist burnout.  When combined with our general outlook about whether the universe is a fundamentally helpful or destructive force, we have an equation that drives our ability to resist burnout. 

Burnout 

Burnout is characterized by exhaustion, cynicism, and inefficacy.  It’s the loss of hope that our situation will get better.  It’s the belief that nothing can be done, so we descend into cynicism about the situation. 

Our hope is built on the premise that either something outside of us will make things better or we will.  There’s little that we can do to change our fundamental outlook about the universe, but it’s possible to change our belief in ourselves. 

Fundamental Outlook 

We’ve heard about optimists and pessimists and the philosophical question of the half full or half empty glass.  Similarly, some of us are wired – through our genetics and our experiences – to believe that the world is a fundamentally helpful place.  We believe that things will get better by the sheer fact that the universe will deliver us a solution at some point. 

Conversely, some of us are wired to believe that the world is a harmful place bent on our misery and destruction.  For those of us who fit in this category, we not only expect that our situation won’t get better, we expect it will get worse – unless we step in to change the outcome. 

Self-Trust 

Self-trust is our belief in ourselves.  It’s our belief that we’ll keep our commitments to ourselves, and that we’ve got the personal agency we need to overcome the challenges that are placed in our way.  This trust and determination can carry us through difficult times and even setbacks. 

Self-trust allows people who believe the world is harmful to also believe things can get better.  The good news is that we can improve our self-trust with two simple steps. 

Keeping Our Commitments – To Ourselves 

We’re all guilty of committing to one thing and doing another.  There’s a subset of us that makes New Year’s Resolutions.  Of those who do, the statistics aren’t good about our ability to keep our resolution.  Whether the commitment was to exercise, eat better, or do more philanthropy, sometimes we just don’t meet our commitments.  However, the question is whether that’s the norm or whether that’s a rare exception. 

The more we are conscious about meeting our commitments to ourselves, the more we can believe in our ability to do what we set out to do.  Rather than dwelling on the times we miss our commitments to ourselves, we can focus on the times when we do.  It’s too easy to dismiss the hard work needed to meet a goal.  Once we’ve honored a commitment we made to ourselves, we discount it.  If we want to build self-trust, we should keep a list of these successful commitments.  This way, we can realize that, most of the time when we make a commitment to ourselves, we meet it. 

Personal Power 

The truth is we don’t have control of the outcomes.  We may have a large degree of influence in some situations and less influence in others, but we don’t control the outcomes.  To increase our self-trust, we first realize that we don’t have control – but, with enough influence and time, anything is possible.  Consider that the Grand Canyon was carved by a river.  It didn’t dig it in a day, and it didn’t have ultimate influence, but the Grand Canyon was carved over time nonetheless. 

We can enhance self-trust in our abilities by focusing on what we have gotten accomplished, even when we didn’t accomplish our end goal. 

If you want to stop the slide into burnout, one good approach is to learn how to trust yourself more.  You can do that by keeping your commitments to yourself and focusing on the things that you have accomplished. 

Manage Demands to Maintain Personal Agency

This excerpt is adapted from Extinguish Burnout (SHRM, 2019) by Rob & Terri Bogue. It is the third in a three-part series on the effect of burnout at work.

Our belief that we’re personally able to change our world, that we have control of our results in life, is a deep-seated belief that some might call a delusion. It allows us to proceed through our days without the fear that we’ll be wiped out by an asteroid tomorrow. Belief in our personal agency needs to find a place in the middle between powerless and omnipotent. We need to find an understanding of what we can and cannot do. 

Originally published on SHRM.org. Read the full article here: https://www.shrm.org/ResourcesAndTools/hr-topics/employee-relations/Pages/Manage-Demands-to-Maintain-Personal-Agency-.aspx

Calibrate Expectations to Prevent Burnout

This excerpt is adapted from Extinguish Burnout (SHRM, 2019) by Rob & Terri Bogue. It is the second in a three-part series on the effect of burnout at work.

In the light of cynicism and the idea that nothing you can do will make things different, it’s easy to see why the lack of perceived personal effectiveness may be the start of burnout. Before it has reached its full development, where nothing is possible any longer, burnout starts as the feeling of not doing enough. 

Originally published on SHRM.org. Read the full article here: https://www.shrm.org/ResourcesAndTools/hr-topics/employee-relations/Pages/Calibrate-Expectations-to-Prevent-Burnout.aspx

Navigating Burnout by Trusting Your Instruments

Steve Jobs dropped in on a calligraphy course at Reed College, and it changed the world of computers.  Jobs took the knowledge of calligraphy to design the font system for the Apple Macintosh system, and that’s helped to transform computers from green-screen typewriters to the beautiful design systems that we have today.  Sometimes, what you learn randomly can be powerful in your life and the life of others.

Just one of the lessons that every pilot is taught can help you prevent burnout in yourself and others.

Perception of Burnout

Burnout has classically been defined as exhaustion, cynicism, and inefficacy.  However, your actual efficacy makes little difference to whether you’ll be in burnout or not.  What matters is your perception of your efficacy – not reality.

If your perception is connected to and grounded in reality, then you can accept that your actual efficacy would impact your burnout – or not.  In most cases, you and your people are effective it’s just that you don’t believe you’re productive – or productive enough – and that can lead to a crash.

A Pilot’s Instruments

Even visual pilots are taught like instrument-rated pilots.  A visual pilot can only fly when they can see outside the windows.  Instrument-rated pilots are taught to safely fly in nearly any kind of weather.  However, there’s a recognition that visual flight pilots may find themselves in bad circumstances, so they receive basic training on how to use their instruments when they get in trouble.

The first part of the training – and every part of the training after it – focuses on the need to trust the instruments.  Trust the instruments when your internal perception of what is happening doesn’t match what the instruments are saying.  Your own internal sense of what happening doesn’t have the precision the instruments have.

The common complaint is “What if the instrument fails?”  Though failures are rare, they do happen.  That’s why aircraft have multiple instruments that can communicate the same information.  They are sourced off from two different sets of inputs.  If you have two instruments saying you’re descending or turning, they’re right, whether you like it or not.

Relationship to Efficacy

When it comes to our efficacy, we don’t have the kind of precision that aircraft flight instruments offer, but we can leverage the feedback we receive from others to cross-check how we feel we’re doing with our efficacy.  If we’re getting feedback from our manager that our facilitation skills are great, whether we feel good about them or not, we know that we’re effective.  If our presentations are met with high marks and positive comments, then we know that they’re good – even if we don’t feel it.

Of course, just like instruments in an airplane can fail, so, too, can our feedback fail us.  Some people, including managers, won’t give us the candid feedback we need.  Sometimes, people may feel as if they’re competing with us and will give us negative marks to bring us down.  However, for most people, the feedback we receive will cluster around the right answer.  By cross-checking the feedback from different people, we can figure out what data might be bad – and, like a bad flight instrument, we can learn to ignore it.

Testing Efficacy

If you’re struggling with burnout, the path forward relies on trusting your instruments – the feedback that you’re getting – instead of how you feel.  On July 16, 1999, John F. Kennedy, Jr. left on a flight to Martha’s Vineyard.  According to the official NTSB report, he encountered low clouds.  He stopped trusting his instruments and instead began to rely on his own flawed perception, resulting in a crash.  How do you learn to trust your feedback, so you don’t crash into burnout?

Where Does Burnout Come From?

This excerpt is adapted from Extinguish Burnout (SHRM, 2019) by Rob & Terri Bogue. It is the first in a three-part series on the effect of burnout at work.

Burnout is classically seen in three factors: exhaustion, cynicism, and lack of personal effectiveness. Of these three components, which are candidates to cause burnout? In other words, which came first: the proverbial chicken or the egg?

Originally published on SHRM.org. Read the full article here: https://www.shrm.org/ResourcesAndTools/hr-topics/employee-relations/Pages/Where-Does-Burnout-Come-From.aspx

Managing Demands and Preventing Burnout

Learning how to manage the multiple demands placed on you is an important part of managing your personal agency and guarding against burnout.  Managing demands is sometimes as easy as saying no – and sometimes it’s more complicated.

Burnout

In the first blog in our series, Thrive, Don’t Just Survive, we first defined burnout as the perception that you cannot change your environment and thus have no personal agency (your ability to get things done).  Burnout is frequently defined by exhaustion, cynicism, and inefficacy.  It’s what happens when we feel we have depleted our personal agency.  It’s when we feel like we don’t have any ability to make a change.  While our results, the support we receive, and our self-care fill up our personal agency, demands drain us.

The Valve on Demands

It’s commonly overlooked, but there is a valve on the demands that drain us.  We can say no, and we can manage our demands, so they don’t overly deplete our agency.  Often, we forget that, just because someone wants something from us, doesn’t mean that we must give it.

We don’t have to join the PTA, host the neighborhood watch meeting, agree to work overtime, or any of the other dozens of things that may ask for our assistance.  You can decline requests and save your ability to get things done for another situation or another cause to ensure you have enough reserves.

It gets harder when you need to say no at work to a peer, a manager, or someone on the team.  The reasons for saying no are different.  Some of the reasons for saying no are appropriate but have nothing to do with your need to manage personal agency.  When things are wrong or you can’t agree, then no is the right answer.  In business situations, after a polite no, it’s a good idea to start a dialogue about what is possible, whether your no is due to a disagreement or a need to maintain your agency.

When You Shouldn’t Say No

While it’s true that we can always manage our demands by saying no, there are times when this isn’t the right answer.  Sometimes the right answer is to persist, meet your commitments, and decide how to manage your demands in the longer term.  If there’s a crisis that your job requires you step into, it’s not a good time to say, “No, I don’t think I have the personal agency to support this.”  As healthcare providers, we are frequently required to act urgently for our patients, even if the condition isn’t life-threatening.  It’s incumbent on you to maintain reserves so that you can be ready for these circumstances.

The time to say no isn’t in a moment of crisis.  The time to say no is when you’re planning your activities, when you’re making the decision to pick up that extra shift, fulfill that extra committee role, or take on an extra project.  Once you’ve made the commitment to take care of a patient, you’re committed, whether you feel you have the capacity or not.

There are times when it feels like there is a gray area of what you can refuse and when you really cannot say no.  Where do you turn for help if you are unsure if you have the right to refuse?  Refer to your state’s Nurse Practice Act, your employer’s legal team and official policies, and Nursing Scope and Standards of Practice and Code of Ethics for Nurses.

Over Your Head

Just because you can’t say no in a moment of crisis doesn’t mean you shouldn’t ask for help – you absolutely should.  It is important to remember that asking for help is not a sign of weakness.  In truth, it is a sign of self-awareness and strength.  Whatever your capacity in a crisis is, the answer isn’t to stand alone or tough it out.  Instead, you should ask for support, so that you can share the load with others.  The more help that you can get from others, the less you have to carry.

Of course, you should equally be willing to support others when they call for help – even if they’re not good at calling for help.  Sometimes, supporting others means watching for situations where they may need help and proactively offering or providing support.

Learning how to manage the multiple demands placed on you is an important part of managing your personal agency and guarding against burnout.  Managing demands is sometimes as easy as saying no – and sometimes it’s more complicated.

Burnout

In the first blog in our series, Thrive, Don’t Just Survive, we first defined burnouts as the perception that you cannot change your environment and thus have not personal agency (your ability to get things done).  Burnout is frequently defined by exhaustion, cynicism, and inefficacy.  It’s what happens when we feel we have depleted our personal agency.  It’s when we feel like we don’t have any ability to make a change.  While our results, the support we receive, and our self-care fill up our personal agency, demands drain us.

The Valve on Demands

It’s commonly overlooked, but there is a valve on the demands that drain us.  We can say no, and we can manage our demands, so they don’t overly deplete our agency.  Often, we forget that, just because someone wants something from us, doesn’t mean that we must give it.

We don’t have to join the PTA, host the neighborhood watch meeting, agree to work overtime, or any of the other dozens of things that may ask for our assistance.  You can decline requests and save your ability to get things done for another situation or another cause to ensure you have enough reserves.

It gets harder when you need to say no at work to a peer, a manager, or someone on the team.  The reasons for saying no are different.  Some of the reasons for saying no are appropriate but have nothing to do with your need to manage personal agency.  When things are wrong or you can’t agree, then no is the right answer.  In business situations, after a polite no, it’s a good idea to start a dialogue about what is possible, whether your no is due to a disagreement or a need to maintain your agency.

When You Shouldn’t Say No

While it’s true that we can always manage our demands by saying no, there are times when this isn’t the right answer.  Sometimes the right answer is to persist, meet your commitments, and decide how to manage your demands in the longer term.  If there’s a crisis that your job requires that you step into, it’s not a good time to say, “No, I don’t think I have the personal agency to support this.”  As healthcare providers, we are frequently required to act urgently for our patients, even if the condition isn’t life-threatening.  It’s incumbent on you to maintain reserves so that you can be ready for these circumstances.

The time to say no isn’t in a moment of crisis.  The time to say no is when you’re planning your activities, when you’re making the decision to pick up that extra shift, fulfill that extra committee role, or take on an extra project.  Once you’ve made the commitment to take care of a patient, you’re committed, whether you feel you have the capacity or not.

There are times when it feels like there is a gray area of what you can refuse and when you really cannot say no.  Where do you turn for help If you are unsure if you have the right to refuse?  Refer to your state’s Nurse Practice Act, your employer’s legal team and official policies, and Nursing Scope and Standards of Practice and Code of Ethics for Nurses.

Over Your Head

Just because you can’t say no in a moment of crisis doesn’t mean you shouldn’t ask for help – you absolutely should.  It is important to remember that asking for help is not a sign of weakness.  In truth, it is a sign of self-awareness and strength.  Whatever your capacity in a crisis is, the answer isn’t to stand alone or tough it out.  Instead, you should ask for support, so that you can share the load with others.  The more help that you can get from others, the less you have to carry.

Of course, you should equally be willing to support others when they call for help – even if they’re not good at calling for help.  Sometimes, supporting others means watching for situations where they may need help and proactively offering or providing support.

The Impact of Trust on Burnout

Are you a trusting person?  The question isn’t whether you’re trustworthy but rather how easy do you find it to trust others.  The answer to this question may be the key to why you’re stuck in depression or why you’re relatively resilient to it.  The reason is all about your beliefs.

Trust is a Belief

Whenever you say you trust someone, you’re stating a belief.  Your trust, properly understood and tested, has limits and conditions.  When you say that you trust your accountant, you’re saying that you trust them to do your taxes.  When you say that you trust your babysitter, you’re saying you trust them to safely watch your child.  However, you likely wouldn’t let your accountant watch your child or your babysitter do your taxes.

Does your belief mean your accountant can’t make a mistake?  Of course not.  However, trusting your accountant is a simplification.  If you can’t trust your accountant, you’ll have to learn enough about your taxes to verify their work.  The desire to offload the responsibility for understanding the complicated tax code is why you hired an accountant in the first place.

Trust with Betrayal is Better

If you know that, at some point in your life, your trust will be unfounded, and someone will definitely betray your trust, should you still trust?  The answer is still yes.  The benefits that you get from appropriate trust outweigh the occasional betrayal.  The value of trusting others is that you don’t have to verify everything, which is time-consuming and exhausting.

Certainly, if you’ve recently been betrayed, it’s hard to accept that you should have trusted in the first place.  Surely the consequences of the betrayal mean that your net psychological gain-loss statement is negative.  It can be – and at the same time, overall, your trust has served you well.  Think of all the things that you didn’t have to verify.  How many meals at restaurants did you not have to prepare?  How many airplane flights ended successfully without you having to fly the plane?

As painful as a betrayal is – whether intentional or unintentional – it often doesn’t stand up against the weight of the verification and loneliness that becomes the only other option.  Betrayal is an important signal to improve whom you trust, for what, and for how long.  At the same time, it’s important to not sink into the belief that you’ll never trust again.

Trust That It Can Get Better

Burnout is only developed or sustained when there is a belief that things will not get better.  Burnout says that nothing you do matters, because you don’t have control or influence over the outcomes.  However, the alternative belief, that the current situation is temporary and things inevitably will get better, can immunize you from being infected by burnout.  The belief – the trust – that things will get better means whatever negative you’re enduring today, including a betrayal, is brief and temporary.

Trust Touches Everything

If you’re struggling to develop positive beliefs, you can start with beliefs that are easy.  You can believe in gravity, or that the sun will rise in the east tomorrow.  For most people, these are certainties that are easy to believe in.  From there, we move to the things that we inherently trust.  While this varies based on individual backgrounds, you may believe your parents will always love you, your friends will always accept you for who you are, or you’ll always “land on your feet.”  From there, it’s possible to extend trust, slowly and carefully, into areas where you’ve been betrayed, and into the space that it will get better, thereby using the power of trust to ward off burnout.

Avoiding Burnout by Rewiring for Happiness

It’s an unfortunate fact of life that evolution has shaped us to be more concerned with the negatives that happen to us than the positives.  If there’s a choice to worry about a lion hiding in the grass, the human who worried survived.  As a result, we’re predisposed to worry, be concerned about, and focus on the challenges we face instead of the opportunities.  However, as humans, we’re gifted with conscious awareness and a rational mind that can sometimes grab the reins of our historic perspectives and shift them a bit.

Happiness and Burnout

Burnout is caused by a feeling of inefficacy.  Those feelings flow more freely when you’re focused on the negative.  It’s easier to feel like you’re not making enough progress when you’re focused on the setbacks instead of the opportunities.  When you can refocus your attention on the things that make you happy and the things that are going well, you naturally feel as if you’re making more progress, you’re more effective, and life is better.

We tend to believe that we can compartmentalize our general mood and feelings into buckets and keep them from interfering with other areas of our lives.  However, research shows that our emotions in one area of our life bleed into other areas without our knowledge.  Stress reduces our creativity and our compassion for others – whether we’re aware of it or not.

Changing Happiness

Part of our happiness is defined by our genetics.  There’s a predisposition to a certain happiness level – sort of like setting a thermostat on the wall.  All things being equal, the heating and air conditioning will try to keep the temperatures set.  However, we can light a fire in the fireplace – which isn’t under the thermostat’s control.  While there are many ways to increase our happiness, two are particularly powerful: gratitude and savoring.

Gratitude

For most of us, meals are routine.  We enjoy a good meal, and we don’t give it a second thought.  Years after leaving home, children realize they took for granted what a great cook mom was.  We become accustomed to goodness and fail to realize how good things are now.  We can hold on to these things by making the conscious decision to catalog what we’re grateful for each day.

This might take the form of a gratitude journal, in which you write the things you’re grateful for each day.  The key point isn’t the writing.  The key point is to reflect on the day and recognize the good things.  It’s easy to succumb to our biology and focus on the negative, but by focusing on the positives, the things that we’re grateful for, we can shift our general mood and level of happiness.

When we recognize that more good things happen than bad, we lift ourselves out of the swamps of unhappiness.

Savoring

Recognizing the good things that are happening to us is a start, but unless you’re willing to dwell in them, they’ll still pass by too quickly.  That’s where savoring comes in.  Just like the idea of letting a forkful of a delicious meal sit on your tongue before chewing and swallowing, we can allow ourselves to experience the positive of the moment longer and more deeply before moving on.

Once you’ve built a habit of gratitude, you can apply it to your daily routine.  Instead of waiting until the end of the day, you can become more able to recognize good things when they happen – and savor those moment.  When someone holds a door for you, you can consider how the world is improving, how you’re a human worthy of respect and assistance.  Just lingering in these thoughts for a few moments is enough.

With these two simple techniques, you can develop your happiness, and ultimately help keep yourself out of burnout.

Self-Care or Self-Indulgence

Drawing the line between self-care and self-indulgence is a tricky proposition.  How much time should you spend recharging before returning to the battle to help others?  There is, it seems, no single right answer.  We know that we need to care for ourselves, yet when we’re doing that, we’re not sharing our concern with the rest of the world.

The problem is one of debt.  Not financial debt but a relational debt that we owe to ourselves.  We can continue to give and give, but eventually we’ll end up consuming our reserves, and we’ll start to borrow from our future in terms of our physical or mental well-being.  The debt service – the additional psychic cost – of being so depleted is debilitating.  Protecting ourselves from getting into this psychic debt should be and remains a priority.

The kind of thing that can keep us from psychic debt is an appropriate amount of self-care.  But what separates self-care from self-indulgence?  The short answer is the long-term impact.  Consider for a moment the idea of binge-watching your newest obsession with a television series.  It will likely be enjoyable and feel good for the moment, but, in most cases, it will bring no lasting joy, nor will it make you feel particularly refreshed.  As a result, it would fall under the category of self-indulgence.

It’s important to pause here and say that self-indulgence is necessary in appropriate amounts, just like food is necessary for our body – but it can be overdone, leading to obesity.  We need to accept that we can’t be “on” all the time.  We need to accept that there are times when self-indulgence is the right thing.  The key, however, is to not confuse the occasional self-indulgence with self-care.

Self-care leaves us with the residue of long-lasting benefits.  Each time we perform self-care, we develop a deeper understanding of ourselves or the world or the way we want to transform ourselves or the world.  Self-care makes the demands that we face in the future a bit lighter and strengthens our inner fortitude so that we can go out in the world and help others with bigger loads for longer.

Self-care might look like meditation, exercise, a contemplative walk in the woods, or a myriad of other things that build our long-term capacity to be ourselves, accept ourselves and our world, and, ultimately, sustain ourselves for longer.  Instead of a psychic debt, we build a psychic storehouse that’s stocked with the energy we need to persevere through long periods of intense load.

So, in the end, the difference between self-indulgence and self-care is simple: long-term impact.  The only complication is that sometimes that self-indulgence is self-care.  Sometimes you have to accept that the decision to allow yourself some self-indulgence is in itself developing a greater sense of acceptance and love for who you are and your need to be human – as long as the self-indulgence doesn’t go too far.

Burnout, Depression, or Both?

How can you tell if you’re just down, you’ve got depression, or you’re being consumed by burnout?  Sometimes, the official answers aren’t so useful.  Officially, depression is diagnosed based on the time and appropriateness of feeling down.  For instance, the loss of a loved one should cause someone to feel down – even for an extended time.  However, in general, the guidelines are a depressed persistent mood for longer than two weeks.

So how do you know if you’re suffering from depression directly, or if you’ve got burnout that’s leading to depression?  Being burned out increases the chances that you’ll develop depression, so perhaps burnout is the root cause of the malady of depression that you feel.

The real problem is what we call “depression” is such a broad category of things that it’s difficult to pinpoint a single cause.  From chemical imbalances to self-talk or self-image issues, depression can come from many sources.  Finding the root of depression keeps many counselors busy, and despite good work, counseling often seems to have limited ability to locate and eradicate the root cause.

One of the challenges is that we get so focused trying to find the source of the depression – the root cause – that we forget that many of the ways that are used to defend against and recover from burnout are the same techniques used for depression – regardless of the source.  We’re so worried about finding the cause, that we forget to focus on the cure.  Certainly, in some things, it’s essential to find the root cause, but in others there may not be any one root cause.  There may only be a set of causal factors that lead to the situation – none of which, if individually identified and resolved, solve the issue.

Whether you’re suffering from burnout, depression, or both, you may find that being more aware of the support you receive from others – and not discounting it – will lighten your burden.  Perhaps it’s learning to view the results you see from your efforts in a different light that will make things a bit brighter.  Maybe the challenge for you is learning how to set boundaries and develop decision-making criteria that will allow you to say no without feeling guilty.

Ultimately, the most powerful approach to dealing with burnout or depression is changing the way that you view yourself in terms of both your self-talk – the way you talk to yourself – and self-care – the way you take care of yourself.  If you can change the way that you talk to yourself to be more loving and more accepting of who you are, you’ll feel less internally-generated shame, and it will feel less like walking around in muck.  If you can learn effective self-care strategies, you can feel like you’re not indulging yourself, you’re rejuvenating yourself.

In the end, it may not matter whether you’re suffering from burnout, depression, or both.  It may be that your real goal is simply to find approaches that allow you to grow out of whatever pit that you’re in.