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.