Burnout conspiracy?

Burnout- that's the first time I used the word. First off, let's get a good definition and then we'll talk about if I have it or if you have it!

Some of you may wonder why I care so much about my profession to do all this work on my time off. Again, my personality type - EMFJ states that I must do something that I am passionate about. Since burnout has been defined as “erosion of the soul” (Thomas Skovholt, The Resilient Practitioner) and a loss of will to do the work, something more serious than the need for a vacation, Confucius say that I must uncover the rediscover my enthusiasm for the profession or forget it all together.

Traditionally, the word “burnout” was used to describe people who can't handle the pressures and everyday stresses on the job and continues to be perceived as an individual problem or personality flaw.

Schultz, Greenley and Brown (1995) define burnout as "emotional exhaustion and depersonalization, and reduced personal accomplishment [occurring in response to] the chronic emotional strain of dealing extensively with other human beings when they are troubled or having problems” (pg. 333). In other words, people burnout because they can't deal with clients.

How many social workers have been approached by people who say, "God, you are so noble"? Many of us are irritated by this statement and rebel stating, "I can handle my clients. I'm the type of person who can put up with this". Sure it takes a certain type of person to deal with trauma, resistant clients and personal hardships. Thus, the first thoughts about burnout are, “if I have it, I'm not admitting it because that means maybe I can't handle this work”. After putting up with my last job, I realized that I already blamed myself for everything, so why not move closer to that anxiety and explore it.

So I read books about people who are likely to experience burnout. Staff characteristics that contribute to burnout have higher levels of education and less experience (Schultz et. Al, 1995). This seems to indicate novice professionals are burning out right out of graduate school, or when they are forming professional identities. This indicate that the newbie isn't able to deal with the profession.

Grosch and Olsen (1994) state that many people do social work for the wrong reasons and are more likely to get burnt out. In other words, it is healthy for helpers to help others make sense of things, but unhealthy to make quick judgment. It is healthy to live vicariously, but be cautious of over-involvement. Listening to clients can be an adventure, but invasion is a risk. It is healthy to feel useful and needed, but you can't only feel useful and needed at work. Well, I assess myself high on the “ability to set boundaries scale” and this viewpoint has been backed up by colleagues. Boundaries are important because you can't be of use to others if you're sick of them. So , check- this isn't my problem.

Next step, if taking time off doesn't resolve anxiety about burnout, then do a genogram to resolve family of origin issues. Cool, let's resolve some Oedipal issues! I learned about fusion and cutoff (extremes in the Murray Bowen family continuum) that respectively mean over-involvement on a family system for identity or complete removal from family system. I even learned about the process of over-functioning, when parents don't functionally take charge so the kid picks up the slack. C'mon now guys, who has a functional family?I consider myself pretty lucky in the sense that I didn't have the shit beat out of me by anyone or get sexually abused. I did over-function in my family when I was 19 because my parents went through a divorce, but was this the reason that I was having trouble in social work? In Bowen's words, I was, in fact, “differentiated” from my family. So, check, family of origins really doesn't seem to be the problem either.

That leaves the one thing I can't control, the environment. More recent researchers have actually started to consider work environments where people are more likely to burnout. Thank god, maybe it's not all my fault.

Okay, that hits the spot a bit more- yes, the anxiety, frustration level is rising. In my opinion, it takes a god damn saint or a martyr (which I definitely am not) to put up with stressful clients plus a non-supportive work environment, incapable leaders, hostile management and little to no reward (financial and otherwise).

Now, you say, who is this girl trying to blame? Obviously there is something inherent about me that has made me more likely to burnout in my job (Person in Environment), but to read this over and over again that there must be something wrong with me if I can't deal, perpetuates a process which raises anxiety (enough of that) and keeps me living in the past. Here is the dichotomy of Psychoanalysis and acceptance. Acceptance needs to be practiced in order to move forward and abandon self blame and psychoanalysis is all about self-blame. Interesting how those of us who are prone to self-blame continue to self-psychoanalyze, while those who are prone to blame others continue to be solution focused.

In order for my anxious self to move on, I meditate on Pema Chodron's ideas that we can't know everything, and to think that we do is arrogant. Attempting to pick apart the mysteries of my life is a useless task. I am grateful for my childhood and my family. It's the past two years that have been of ultimate frustration and anxiety. That leaves the “family” of people at my job, (the I-Ching calls it Chia Jen) which is also in line with Bowen's theory- The Eight Concepts (Gilbert, 2004). Bowen states that a work team is just another family looking for balance. That doesn't mean that it's not fucked up. So forward movement, as the I-Ching says is to concentrate of myself as a part of this family (weird how on base that thing is. It's like it works or something!)

Therefore, I move the the concept of burnout as related to the work environment.

Here are a few tidbits of information that talk about the importance of a good learning environment on the job:

In the book When Helping Starts to Hurt, Grosch and Olsen (1994) talk about burnout as a result of the interplay between a person and his environment. Gallacher (1997) shows the importance of supervision, guidance and mentorship in the profession: "quality control in which the supervisor is responsible for monitoring employee performance; personnel development in which the supervisor is responsible for helping practitioners refine their skills and elaborate ... discipline-specific knowledge and their technical competencies; promoting commitment to the field and position, which, in turn, enhances motivation”. If this process is not effective, it seems that in turn, the employee loses motivation and burn out might be related to inappropriate mentorship.

Thomas Skovholt talks about the need for appropriate supervision during the early stages of practitioner development. Early stage practitioners are “fragile and incomplete” and need someone to guide, mentor and lead them. When these things are not provided the novice experiences a substantial level of anxiety which can be debilitating.

"Results show that a team organization structure, transformation and transaction leadership, and a clan culture are antecedents to a favorable work environment that leads to job satisfaction and less burnout” Schultz et al, pg. 340).

A positive work environment includes 1. job clarity, 2. goal congruence, 3. staff autonomy, 4. participating by staff- so they feel a sense of self efficacy and contribution. BINGO! If we're all on the same page – job role and goal congruence - even if we don't agree, but simply understand where everyone is coming from, if we understand how much freedom we have in decision making (autonomy) we feel like we are learning ourselves.

Other concepts of importance are 1. positive leadership, 2. organizational culture. I think we could safely say that my organization had a "cult", not necessarily a culture. With no understanding of my job role, goal congruence and no ability to participate, I had no self efficacy. While I was hired to not only be a clinician but to help be a part of developing a newer branch of the organization, it was my understanding that I was supposed to help develop new ideas. However, my supervisor's unwillingness to discuss ideas made me think either I was stepping on her toes, or that she did not agree (despite my attempts to clarify job role) and eventually caused me to feel stonewalled and back down.

http://links.jstor.org/sici?sici=0022-1465(199512)36%3A4%3C333%3AOMACEO%3E2.0.CO%3B2-9#abstract

Two other books that look at the person in their environment theory are Lillian Glass's Toxic People and How to Deal with Difficult People at Work. They mainly talk about the fact that each individuals react differently to other individuals, especially supervisors. We all have someone who is “toxic” to us and it simply means we have to learn tactics to either, “unplug” or “deal” with them. It depends on what is less damaging. She is non-judging about people who choose to unplug saying sometimes we need to self-preserve.

Bowen family theory often talks about the importance of a leader differentiating while leading a group. Ironically, they are looked at as more of team player when they are clear about their own principles and identity.

Thus, it becomes evident that much of the effects of burnout can be attributed to a lack of differentiated leadership.

I need to make a statement on where I am going with all this information. First off, no matter how many books I read, I have not yet discovered the one with the best advice at all.

Quit your job. I went to three therapists for almost a year total going back and forth, weighing my options asking for feedback. The only thing that I got was increased anxiety because I felt it was my problem. Another truth about burnout (Maslach) is that you will feel like you are wrong. The agency, and even other therapists will make you feel crazy because burnout is thought to be your problem. No one pays attention to it, and no one validates it (families, friends, psychiatrists, helpers). Therefore, while the individual struggles to rectify the problem, they intensify it's symptoms rather than gaining validation and understanding. This is magnified for social workers because burnout is a loss of faith in the profession, so the first thing you need is guidance from a professional. As I reached out to the profession for help, I got aloofness and complete lack of opinion which validated and exaggerated my hatred and anxiety towards the profession.

I only quit my job because my massage therapist finally said, “you sound like an abused woman when you talk about your job. Don't stay there. Get the hell out, you're making yourself crazy. It's not you it's the agency”. This statement expressed an opinion and feedback. I have felt crazy for two years and the only objective person that could get through to me was not the person in the profession (the mentor, the leader, the guide) that I needed help from, it was a person in a totally different profession who has not yet been brainwashed.

What I need to clarify for myself is 1. what happened back there was not me and 2. that anyone in position would have broken down. I am a natural leader, I enjoy taking a stand and I understand adversity. How then did I back down against this type of adversity- why was I not strong enough?

My current purpose seems to be to use my frustration about my job (writing about it and exposing it) towards a bigger issue. The idea that social work as it stands is a cult. Only with exposure can light be shed on why and what to do about it. Given the fact that there are not many outraged social worker blogs, I feel a need to talk about this. There needs to be a complete revamping and that starts with someone BIGGER than the individual (Maslach). It starts with specific criticism of the system and how it affects the individual.

Personality Types

I guess I left myself with some food for thought in the last paragraph of my last blog. I started thinking about why I get more pissed off than other people in social work, thus, personality types of people in the profession. I recently revisited a shortened Meyers Briggs/Jung personality test on-line. http://www.humanmetrics.com/cgi-win/JTypes2.asp. I discovered that I am an ENFJ, which means Extroverted, Intuitive, Feeling and Judging (interestingly enough, only mildly judging- which you guys are probably wondering how that is possible given my rampage about street kids).

I believe that social workers have three personalities. 1. personal self, 2. client self and 3. professional self. This doesn't mean that we ALL do, but that we should. We need to behave differently with our clients than we do with our friends, and be aware of professional culture. (In When Helping Starts to Hurt, Grosch and Olsen (1994) talk about professional development as a separate, but parallel identity development which they relate to the Susan and Sheridan model (1985) including the following stages. 1.ID vs role confusion 2.competence vs inadequacy 3.productivity vs stagnation 4.re-dedication vs disillusionment.)

ATTITUDE:

As a social worker (client self), I am very open minded because this is PART OF MY JOB. If clients are out of line, I'll say, "that was inappropriate", because most likely if they make inappropriate remarks in group, they are probably getting into trouble in real life. As professionals, we can't choose all our clients, so just because a client is boring, doesn't mean I wouldn't treat them. To do this would be ignoring a challenge in the profession.

On a personal self level, I am opinionated and expressive, get excited easily and discuss new ideas as they arise. This serves a purpose: adding something to conversations and putting my mark out on the world. In college, I loved to talk with a variety of people about class about loving or hating professors and theories. Exchange makes me feel stimulated, like I am learning and connecting with people, and hence good about myself. People don't have to be similar to me to interest me, but have a similar passion for life. One of my best friends LOVES Britney Spears, Rush Limbaugh and hates the Beatles (for real). We argue about everything from skin cream to Bill Clinton, but I admire her zest for life, excitement about ridiculous things that are always changing, and her passion. When I see spark that drives people to enjoy what life has to offer, it makes me want to learn about them.

On a professional level, it is not possible to always choose your colleagues. Therefore, it is more a matter of learning to deal with different personality types, which given the nature of my personal relationships, I give myself some serious credit.

WHAT I HATE:
Personally: I hate long walks on the beach at sunset (mosquitos) and people who "suck it up". These “suckers”, I'm going to equate them with Scientologists because they don't talk about what Scientology is to outsiders, but try to brainwash you into thinking like them without telling you what that means. They don't explain themselves, their beliefs, tell you anything about themselves, yet they criticize everything about you and think themselves superior- you're the one with the problem- think Tom Cruise with Matt Lauer and his opinions about the history of Psychiatry. "I know the history of psychiatry and you don't...You are glib”. I refuse to get involved with people like this personally. Stay away from the Jehovah's Witnesses guys. It is a cult, not a religion.

Again, can't choose the clients. Working with Scientology clients is difficult, but not impossible. You just have to put up with their evasion tactics. I haven't run across many clients like this. Nevertheless, I want to reinforce that professional frustration with such an issue does not warrant a personal response. Therefore, I would not refuse to treat a client just because they "suck" everything up.

Now professionally, what the hell do you do when you get involved with these people? Good question.

A quick example about how you know you are involved with Scientologists... At my first company training we discussed readying the agency's staff for an impending “change”. I remember someone (who I later learned quit after two months), asking, “what is the goal of the change? Where are we headed?” There was no answer, a common response for our agency. So, wait, we are supposed to be “on board” with a change to which there is no end to a means. After a year and half with the agency, I still didn't know what the means to the end were.

A bit more on these people. They love to make you squirm. With no information, you can ask question after question, but like a good timeshare salesman, you just don't know what you're getting yourself into. Here's an example:

Sample conversation:

Me: “What's your position on that issue?”

Them: “two blocks to the left are three hundred taco stands and they're all good. If you head south, you get to Mexico, and India is a poor country”.

Me: trying to clarify, “alright, well which taco stand is good?”,

Them: “well I think the one with the pink on the menu”.

Me: “I thought there were 300 of them?”

Them: “I heard the fajitas were good”.

Me: “At which stand?”.

Them: “If you want a really good taco, you could go to Mexico.”

Me: “Well, Mexico is really far away and it's a big country and the food differs in every area. Which part of the country do you like the most?”

Them: “I hear the Florida Keys are a good place to take a vacation”.

Me: “Okay seriously now, this conversation has been going on for about 10 minutes and I still don't know what we have agreed to do about this policy and about the client!”.

Them: “Anybody for a donut?”

These people are fucking brilliant. They are able to effectively evade the issues, “suck” your energy and productivity, AND raise anxiety about your professional and eventually personal self, because this treatment is coming from someone who is supposed to be helping you FORM your professional self. If you join them, you're set for life (and not gay, sorry had to say it). If you don't you're fucked. Just like I said, Scientology.

I repeatedly encountered these folks in school and work settings. This was upsetting because it meant that I shared interests (a profession), so, GASP, I might have something in common with them. What? When you attend school to be stimulated intellectually, it sucks to be surrounded by people who don't express opinions or don't have any passion for learning their profession. While they might be upset with their education, they only took it to a certain level. Bitch, but don't sign a petition because you are worried about rocking the boat. I was the only one "held on" to things long enough, or was persistent enough. I always found that persistence pays off.

This attitude worked, sometimes, although infrequently at school. My first day, I went to a multicultural seminar the purpose of which was to make white people realize their privilege. We were instructed to stand in front of the group on a continuum of how we felt towards different words (e.g. privileged, oppressed etc). If we felt uncomfortable, we were supposed to sit down. I guess the teacher didn't expect that a white person would sit down and two others (nonwhite) would follow. When the teacher questioned us I told her because she was perpetuating stereotypes about the fact that all white people have money and privilege and all non-whites don't. The teacher promptly cut me off and said not to interrupt the activity and we were asked to leave the classroom. Later, the teacher came out and asked us how we felt. I expressed that it was important for students to realize we are all different and just because we are from one country doesn't necessarily mean that we all have the same experience. After this experience, I felt good because I attracted a following with taking a stand in class- I had some partners in crime- so I wasn't the only asshole taking a stand.

There were also some more normal people at my field studies who shared my zest for judgement about social workers. After clients left in the afternoon, we would make fun of MSW programs and name our favorite one hit wonder from the eighties. I had a supervisor who call clients swear words in team meeting. This was refreshing to me because the other two days a week, I sat in classrooms with teachers droning on about being PC. This was enough extremism to keep me balanced and sane.

My "friends" at social work school were people who were better than some students, but didn't necessarily share the excitement for life of others. I was worried about expressing my full opinion because if I did, people would shut down. Therefore I often felt I needed to curb my enthusiasm because if I expressed it, people would become quiet or correct me with a devil's advocate statement trying to neutralize the frustration which left me with no venting outlet. I often justified my friends to myself, saying, "she's ok because she likes Dialectical Behavioral Therapy (DBT), but in a class about racism she declared, "oh my God, I'm White" and started crying. Yes, honey, you are White. Did you just realize that racism still exists in the country? So it's like, I like you, but I can't believe how clueless you are. So, I'm surrounded by idiots and instead of continuing to shrug it off and feel separate or different from them, I told myself to stop being so judgmental. This is where the confusion between personal/professional and client self started.

It's human nature that once you spend enough time around a like minded group (opposite of what you think), either you agree, or if you don't, you feel crazy. An extreme example is Stanley Milgrim's experiment on conformity and obedience that might be of interest following the Nazi regime. People conform because they are pressured by the majority or people with power to do so.
http://en.wikipedia.org/wiki/Stanley_Milgram

If you refuse to conform, historically, you get killed. What if you are in uproar because you believe that a profession, the essence of which entails helping people change, is completely hypocritical because we are opposed to examining and changing ourselves? Standing out against the majority gives the individual negative attention (even if the problem lies in the environment), and eventually if there's no one to join forces with, the individual takes on the environmental problem and breaks down. This means that the agency doesn't have to change and the individual is 1. eventually forced to back down (conform to Scientology and find out what it's all about- I have to say that Ron Hubbard does sound like an interesting fellow) or leave the agency.

So, you ask, why don't use my Buddhist training and drop it! Listen guys, just because I'm a social worker does not necessarily mean that I practice what I preach or am a divine being. Most importantly, social work is an important profession to which I have dedicated 6 years of my life. To discover such atrocities, and pull out seems completely unethical. Again, we are supposed to be ethical professionals! We are responsible for exposing this shit right?

At our first staff meeting, I asked for a program booklet, so I could get a job description and a mission statement of our branch of the agency. There was no such thing. I was pretty surprised, but reminded myself this was a new agency. Therefore, I went home and pulled together a proposal that stated, 1. What are the program rules? 2. What is the mission statement? 3. Do we have any clients that we deny services to? 4. What is our stance on mental health? Do we treat clients only with primary substance abuse issues, or also people with mental health issues? 5. What is your role as the administrative supervisor, my role as a worker and what is our role as a team? What decisions do we make as a team, and what do we run by you. When I emailed this agenda for the following team meeting to my supervisor, she became completely silent. She made me bring up the issue at team meeting and asked me what I thought. What I thought, I already said, didn't the email say? I told her and the team I was looking for some clarification on these issues. Did I get any? Hmmmm. No, but don't think I didn't try. Professionally, I jumped to conclusions that I did something wrong personally. How much harder do I work to figure out what the hell I did? The more they slow down, the more I speed up. What do I try next to communicate?

I quickly realized that I was now immersed in the life on Planet Xenu. Being isolated and absorbed in Scientology for a year and a half, I became more depressed and anxious, internalizing the agency's problems. Rebelling caused everyone to look at me with this ultra judgmental, look, but no comment which made me more anxious. TOXIC (think Britney Spears video).

More tomorrow.