Several years ago, because so many in my field were leaving work they trained for and cared deeply about, I began six years of research into the causes of burnout and how it can be addressed and alleviated. This was important to me because burnout was the reason that most gave to leave the work they so cared about.
What is a burnout?
Burnout can be best described as a state of overload, understandable in our fast-paced, 24/7, wired, demanding, ever-changing society. It develops because so much is expected of one – so constantly that it feels utterly impossible to know where to begin.
Signs of burnout are withdrawal; not caring for yourself; loss of sense of personal accomplishment; feelings many are against you; desire to self-medicate with drugs, alcohol, or a combination; and finally complete depletion.
Burnout and depression
While burnout can be confused with depression, and both conditions make one feel as if a black cloud permeates all, depression usually results from a traumatic loss (such as death, divorce, unwanted professional change), as well as betrayal, connivance, and persistent relationship conflicts — or it appears for reasons that are unclear. With burnout the culprit is always overload. My research showed that carefully selected evidence-based self-care strategies in one’s physical, personal, social, and professional lives (where burnout occurs and interacts) will always alleviate and prevent it.
Burnout in marriage
Interestingly, after my research was completed and shared in a published book, “Burnout and Self-Care in Social Work: A Guidebook for Students and Those in Mental Health and Related Professions,” I began to see clearly that my work on burnout among mental health professionals also applied to pain and depletion in the lives of married couples. Reasons causing it were comparable, and carefully chosen self-care strategies woven into day to day life also alleviated and prevented it.
It is important to note, however, that while marital problems can and often does lead to depression, burnout occurs, not from marital problems, but from overload. (The primary exception to this is when one takes on far too many activities and responsibilities to avoid facing marital problems.) Burnout, however, can and does cause marital difficulties. The examples that follow describe understandable reasons for marital burnout and ways to free oneself from its dangers and depletion.
Sylvan and Marian: Wired 24/7 to a demanding and selfish boss
Sylvan and Marian were each in their late thirties. Married for twelve years, they had two children, ages 10 and 8. Each also worked outside of the home. Sylvan managed a trucking company; his employer demanded constant availability and relentless work. Marian taught fourth grade. “Each of us has so many responsibilities, no time to rest, and no quality time together,” Marian told me in our first appointment. Her husband’s words were also telling, as well as predictable: “We are constantly exhausted and then, when we have a little time together, we pick on each other, as never before. It seems we are no longer friends on the same team.” “Then there’s this participant in our marriage,” said Marian, holding up her iPhone. It is always there, and Sylvan is afraid not to respond to his boss’s constant intrusions in our family life and time. Sylvan nodded to this truth, explaining, “I can’t afford to be fired.”
Here’s how burnout in this couple’s lives ended: Sylvan was an excellent employee, severely underpaid and taken advantage of. He would not easily be replaced, and even in a tough job market his skills and work ethic made him highly employable. He built the confidence to tell his boss that he needed an assistant who could be available to take some of the stress off him, and that unless calls in the evenings and weekends were of an emergency nature, they would have to wait until the next day or the end of the weekend. The strategy worked because of Sylvan’s new found confidence and his employer’s realization that he was not easily replaceable. Also, the couple promised themselves and each other a new part of their life together — regular “date nights,” a necessity in married life.
Stacey and Dave: The toll of compassion fatigue
Stacey was a doctor who worked in a cancer center for children, and Dave was an accountant. They were in their mid-twenties, newly married, and hoped to begin a family within the next few years. Stacey would return home during her work week and withdraw from her husband, turning to several glasses of wine until sleep came.
Our work together concentrated on Stacey’s over-identification with the families she met, the children she treated, and their hardships. It was necessary for her to leave Burnout behind in order to have the strength to continue her work. She had to learn the art of achieving mature perspectives and boundaries. It was necessary for her to see that although she cared deeply for her patients and their families, she and those she worked with were not attached. They were separate people.
It was also necessary for Stacey to look at her chosen work in another new way: Although she had chosen a field where she saw constant suffering, it was also a field that offered enormous hope.
Through these self-care perspectives, Stacey learned that visions of those she worked with and did all she could to help all day long needed to be left at the hospital until she returned. Without this ability, Burnout would render her helpless as a doctor, a wife and a future mom.
Dolly and Steve: The impact of trauma
Dolly was a stay at home wife with twins, a boy and girl age 8. Steve, a pharmacist, tried all he could to help his wife deal with her overwhelming fears, but all of his efforts failed. Married at 20, the constant realities of deaths due to violence that are permeating our society left Dolly with ongoing feelings of helplessness and terror. “I feel that this violence is actually happening to me, my husband, my children,” she told me crying and shaking during our first meeting. Even though I know in my head, it is not, I feel in my heart that it is.”
Further understanding about Dolly and Steve’s lives showed that saving for the future meant that this family had never taken a vacation during their entire marriage. This pattern changed. Now, there is a two week beach holiday each summer at a resort that is reasonable and family oriented. Also, each winter, during school break, the family drives to a new city which they explore together. This quality self-care time has alleviated Dolly’s exhaustion and given her rational perspective and coping skills.
Cynthie and Scott: Piling on responsibilities and activities to avoid facing marital truths
When Cynthie was a grad student at a prestigious university in England, she met Scott, who was handsome, charming, and on the verge of flunking out, which he subsequently did. Never confident in her femininity, Cynthie was overjoyed that such a handsome man desired her. When Scott proposed Cynthie accepted, despite misgivings about the kind of husband and father Scott would be. Knowing that her parents would not approve of this marriage, Cynthie and Scott eloped, and soon after the couple came to America to begin their married life. Cynthie soon found out that her misgivings should have been given far more weight.
While she worked hard to develop her marketing career, Scott was happy to remain jobless as well as open to other sexual relationships. Cynthie’s overriding fear was that leaving Scott would doom her to a lonely, isolated life. To escape these fears and the growing tensions and insults in her relationship with her husband, Cynthie took on more and more professional responsibilities. She even began another master’s degree program in economics. Within months of this decision burnout set in, and Cynthie was referred to me for therapy. After hard work to understand and address her lack of self-esteem and confidence, Cynthie asked Scott to join her in therapy. He refused, demeaning her attempts to address their obvious problems. Cynthie realized after 6 months of therapy that she had been hiding from truths about how she had been living. She knew that the best self-care she could give herself was divorce, and she followed through with this necessity.