Empfohlen
Empfohlen
Weitere Àhnliche Inhalte
Ăhnlich wie London iCAAD 2019 - Dr Philipe Wuyts - BURNOUT HUMANITY - FROM EXCESS TO EXHAUSTION
Ăhnlich wie London iCAAD 2019 - Dr Philipe Wuyts - BURNOUT HUMANITY - FROM EXCESS TO EXHAUSTION (20)
Mehr von iCAADEvents
Mehr von iCAADEvents (20)
KĂŒrzlich hochgeladen
KĂŒrzlich hochgeladen (20)
London iCAAD 2019 - Dr Philipe Wuyts - BURNOUT HUMANITY - FROM EXCESS TO EXHAUSTION
- 1. Dr Philippe Wuyts MD MBA Psychiatrist www.philippewuyts.com ICAAD London 6-5-19 Burnout Humanity From Excess to Exhaustion
- 2. No Relevant Financial Relationships with Any Commercial Interests
- 3. DSM-V Dr Philippe Wuyts - Burnout Humanity - ICAAD London 6th of May 2019
- 4. BURNOUT HUMANITY Dr Philippe Wuyts - Burnout Humanity - ICAAD London 6th of May 2019
- 6. Burn-out is a state of vital exhaustion (ICD-10) Burnout is a syndrome of depleted emotional, physical and cognitive energies, manifested in - emotional and physical exhaustion, - cynical attitudes and - feelings of personal ineffectiveness and incompetence that originates from excessive work- related stress Dr Philippe Wuyts - Burnout Humanity - ICAAD London 6th of May 2019 A Definition
- 7. A Global Phenomenon A Historical Perspective Aetiology and pathogenesis Stress and Burnout Survival Strategies The Information Age Dr Philippe Wuyts - Burnout Humanity - ICAAD London 6th of May 2019 Burnout Humanity From Excess to Exhaustion
- 8. Dr Philippe Wuyts - Burnout Humanity - ICAAD London 6th of May 2019
- 9. Dr Philippe Wuyts - Burnout Humanity - ICAAD London 6th of May 2019
- 10. 1 in 4 workers is affected by the âProfessional Stress Syndromeâ European Agency of for Safety and Health at work - 2011 50-60% of absence from work is related to stress Cox et al. 2000 Report to the European Agency for safety and Health at work Stress related absences cost $3,5 Billion each year in Canada Williams and Normand 2003, Canadian Policy Research Work is the n° 1 source of stress American psychological association The toll of unhealthy workplace practices costs the US health care system at least $200 billion a year Job Stress costs the US Employers more than $300 billion annually The American institute of Stress 13,5 million working days were lost to stress-related absence in the UK Health and Safety Executive, Annual Statistics report for Great Britain, 2012-2013 A recent study estimated that there were 120,000 extra deaths annually in the US from harmful management practices Dr Philippe Wuyts - Burnout Humanity - ICAAD London 6th of May 2019
- 11. Direct Costs âą loss of productivity âą vacancies + training of new employees âą workerâs compensation costs âą Medical (insurance) costs Dr Philippe Wuyts - Burnout Humanity - ICAAD London 6th of May 2019
- 12. âą Instability of the work force âą Reduced collective productivity âą Increased stress and burnout among remaining staff âą Decreased work commitment Indirect Costs Dr Philippe Wuyts - Burnout Humanity - ICAAD London 6th of May 2019
- 13. Dr Philippe Wuyts - Burnout Humanity - ICAAD London 6th of May 2019
- 14. Dr Philippe Wuyts - Burnout Humanity - ICAAD London 6th of May 2019
- 15. Dr Philippe Wuyts - Burnout Humanity - ICAAD London 6th of May 2019
- 16. Dr Philippe Wuyts - Burnout Humanity - ICAAD London 6th of May 2019
- 17. Dr Philippe Wuyts - Burnout Humanity - ICAAD London 6th of May 2019
- 18. Dr Philippe Wuyts - Burnout Humanity - ICAAD London 6th of May 2019
- 19. Dr Philippe Wuyts - Burnout Humanity - ICAAD London 6th of May 2019
- 20. Dr Philippe Wuyts - Burnout Humanity - ICAAD London 6th of May 2019
- 21. Dr Philippe Wuyts - Burnout Humanity - ICAAD London 6th of May 2019
- 23. âElijah Fatigueâ Dr Philippe Wuyts - Burnout Humanity - ICAAD London 6th of May 2019
- 24. A world famous architect is victim of a terrible attack of indifference: he no longer finds meaning or pleasure in life.â Dr Philippe Wuyts - Burnout Humanity - ICAAD London 6th of May 2019
- 25. âBurnout is a state of mental and physical exhaustion caused by one's professional life.â Dr Philippe Wuyts - Burnout Humanity - ICAAD London 6th of May 2019
- 26. 1 The compulsion to prove oneself 6 Denial of emerging problems 12 Burnout 2 Working Harder 3 Neglecting Needs 4 Displacement of Conflicts 5 Revision of Values 7 Withdrawal 8 Odd Behavioural changes 9 Depersonalisation 10 Inner Emptiness 11 Depression Dr Philippe Wuyts - Burnout Humanity - ICAAD London 6th of May 2019
- 27. The Maslach Burnout Inventory (MBI) - 3 Symptom Dimensions: Dr Philippe Wuyts - Burnout Humanity - ICAAD London 6th of May 2019 âBurnout is a state of exhaustion in which one is cynical about the value of oneâs occupation and doubtful of oneâs capacity to performâ - Exhaustion - Depersonalisation - Lack of accomplishment
- 28. Dr Philippe Wuyts - Burnout Humanity - ICAAD London 6th of May 2019
- 29. Dr Philippe Wuyts - Burnout Humanity - ICAAD London 6th of May 2019
- 30. helplessness, hopelessness, irritability Anxiety, insomnia, emotional instability, cynicism depersonalisation and paranoia loss of energy and motivation, chronic fatigue Major depression and generalised anxiety Gastro-intestinal, cardiovascular, dermatological, immunological and Psychosomatic disorders Psychological Physical Social/Behavioural disengagement, Withdrawal, Isolation self-medication, substance abuse and dependence Dr Philippe Wuyts - Burnout Humanity - ICAAD London 6th of May 2019
- 31. poor concentration, decreased productivity and performance ineffective communication, lateness, misuse of breaks Absenteeism, presentism, leaving job âKaroshiâ Loss of Meaning and Faith Feelings of alienation, Despair, suicidality Occupational Existential Dr Philippe Wuyts - Burnout Humanity - ICAAD London 6th of May 2019
- 33. Disposition Situation Dr Philippe Wuyts - Burnout Humanity - ICAAD London 6th of May 2019
- 34. Dr Philippe Wuyts - Burnout Humanity - ICAAD London 6th of May 2019
- 35. Dr Philippe Wuyts - Burnout Humanity - ICAAD London 6th of May 2019
- 36. Dr Philippe Wuyts - Burnout Humanity - ICAAD London 6th of May 2019
- 37. Disposition - âPersonality Traitsâ Dr Philippe Wuyts - Burnout Humanity - ICAAD London 6th of May 2019
- 38. Situation - âWork Environmentâ Dr Philippe Wuyts - Burnout Humanity - ICAAD London 6th of May 2019
- 39. Situation - âWork Environmentâ Dr Philippe Wuyts - Burnout Humanity - ICAAD London 6th of May 2019
- 40. Dr Philippe Wuyts - Burnout Humanity - ICAAD London 6th of May 2019
- 41. are seen as an indicator of commitment, dedication and loyalty to employer are justified on the (false) belief that work output is directly related to number of hours worked. long working hours Dr Philippe Wuyts - Burnout Humanity - ICAAD London 6th of May 2019
- 42. the illusion of Multitasking always connected âI am valuable, even indispensableâ The âGigâ Economy: Freelance, insecure and contingent work âbusy is coolâ Dr Philippe Wuyts - Burnout Humanity - ICAAD London 6th of May 2019
- 43. high work load patient violence and suicide poorly defined roles of consultants limited resources crowded inpatient wards changing culture in mental health services responsibility without authority inability to effect systemic change conflict between responsibility employers vs. patient social isolation Factors that induce Burnout in psychiatrists Dr Philippe Wuyts - Burnout Humanity - ICAAD London 6th of May 2019
- 44. âWorkplace stress is largely ignored by employers, governments and business schools, notwithstanding an enormous epidemiological literature on the effects of workplace conditions on physical and mental healthâ Dr Philippe Wuyts - Burnout Humanity - ICAAD London 6th of May 2019
- 45. Disposition Situation Stress Dr Philippe Wuyts - Burnout Humanity - ICAAD London 6th of May 2019
- 46. Does stress cause Burnout?
- 47. Dr Philippe Wuyts - Burnout Humanity - ICAAD London 6th of May 2019
- 48. Dr Philippe Wuyts - Burnout Humanity - ICAAD London 6th of May 2019
- 49. Dr Philippe Wuyts - Burnout Humanity - ICAAD London 6th of May 2019
- 50. Dr Philippe Wuyts - Burnout Humanity - ICAAD London 6th of May 2019
- 51. Dr Philippe Wuyts - Burnout Humanity - ICAAD London 6th of May 2019
- 52. Dr Philippe Wuyts - Burnout Humanity - ICAAD London 6th of May 2019
- 53. Dr Philippe Wuyts - Burnout Humanity - ICAAD London 6th of May 2019
- 54. Dr Philippe Wuyts - Burnout Humanity - ICAAD London 6th of May 2019
- 55. Dr Philippe Wuyts - Burnout Humanity - ICAAD London 6th of May 2019
- 56. Dr Philippe Wuyts - Burnout Humanity - ICAAD London 6th of May 2019
- 57. Dr Philippe Wuyts - Burnout Humanity - ICAAD London 6th of May 2019
- 58. Dr Philippe Wuyts - Burnout Humanity - ICAAD London 6th of May 2019
- 59. Dr Philippe Wuyts - Burnout Humanity - ICAAD London 6th of May 2019
- 60. Dr Philippe Wuyts - Burnout Humanity - ICAAD London 6th of May 2019
- 61. Dr Philippe Wuyts - Burnout Humanity - ICAAD London 6th of May 2019
- 62. Dr Philippe Wuyts - Burnout Humanity - ICAAD London 6th of May 2019
- 63. Healthy Stress Excessive Stress Accumulated Stress Chronic Stress Burnout Dr Philippe Wuyts - Burnout Humanity - ICAAD London 6th of May 2019
- 64. What about the âSYSTEMâ?
- 65. Burnout is the index of the dislocation between what people are and what they have to do. Dr Philippe Wuyts - Burnout Humanity - ICAAD London 6th of May 2019 It represents an erosion in value, dignity, spirit, and will â an erosion of the human soul. It is a malady that spreads gradually and continuously over time, putting people into a downward spiral from which itâs hard to recover.
- 66. Disposition Situation Stress Dr Philippe Wuyts - Burnout Humanity - ICAAD London 6th of May 2019 System
- 67. Dr Philippe Wuyts - Burnout Humanity - ICAAD London 6th of May 2019
- 68. Volatility Uncertainty Complexity Ambiguity VUCA Vision Understanding Clarity Agility Dr Philippe Wuyts - Burnout Humanity - ICAAD London 6th of May 2019
- 69. âcapitalism is in itself based on domination, manipulation and exploitation of man and nature. The spread of technology is based on the same underlying motives.â Dr Philippe Wuyts - Burnout Humanity - ICAAD London 6th of May 2019
- 70. âNot long ago, only doctors were on call. Dr Philippe Wuyts - Burnout Humanity - ICAAD London 6th of May 2019 Now everybody isâ
- 71. âif meritocrats believe that their advancement comes from their own merits, they can feel they deserve whatever they can getâ Dr Philippe Wuyts - Burnout Humanity - ICAAD London 6th of May 2019
- 72. âExistence becomes objectified as a project of self- idealisation through oneâs profession.â Dr Philippe Wuyts - Burnout Humanity - ICAAD London 6th of May 2019 âThe achievement subject literally competes with himself and exploits himself until he burns out.â
- 73. A bull shit Job is âa form of paid employment that is so completely pointless, unnecessary, or pernicious that even the employee cannot justify its existence even though, as part of the conditions of employment, the employee feels obliged to pretend that this is not the caseâ. Dr Philippe Wuyts - Burnout Humanity - ICAAD London 6th of May 2019
- 75. âLes espoirs Ă©taient grands, la dĂ©sillusion est amĂšreâ âFace Ă cette pathologie de la civilisation postmoderne, la prise en compte des limites de lâhumain est urgenteâ
- 77. Donât Multitask Slow down Decrease your expectations 1. Strategies for the Individual Respect the 80% rule Disconnect from Technology Dr Philippe Wuyts - Burnout Humanity - ICAAD London 6th of May 2019 Embrace SLACK
- 78. Eat healthy Sleep more Reconnect to the Natural World Invest in meaningful Social connections 1. Strategies for the Individual Dr Philippe Wuyts - Burnout Humanity - ICAAD London 6th of May 2019 Move your body (and have sex) Respect your limitations
- 79. Dr Philippe Wuyts - Burnout Humanity - ICAAD London 6th of May 2019Dr Philippe Wuyts - Burnout Humanity - ICAAD London 6th of May 2019
- 80. Dr Philippe Wuyts - Burnout Humanity - ICAAD London 6th of May 2019
- 81. avoid micro-managing empower people encourage more interesting and impactful work Increase job control and autonomy @ WORK âJobs that provide individuals more autonomy and control serve to increa 2. Strategies for employers Increase employee flexibility in working hours Dr Philippe Wuyts - Burnout Humanity - ICAAD London 6th of May 2019
- 82. avoid organisational chaos Improve communication Build a community - Engage employees Improve Social Support @ Work Decrease work hours offer health insurance decrease layoffs decrease family-work conflicts Dr Philippe Wuyts - Burnout Humanity - ICAAD London 6th of May 2019 2. Strategies for employers
- 83. Disposition Situation Stress Dr Philippe Wuyts - Burnout Humanity - ICAAD London 6th of May 2019 System
- 84. Consider introducing a âuniversal basic incomeâ Focus away from Growth - Efficiency - Productivity Dr Philippe Wuyts - Burnout Humanity - ICAAD London 6th of May 2019 Move away from a Consumption-obsessed economic model to a central focus on SUSTAINABILITY 3. Societal proposals
- 85. Revalue ecological policies and priorities Redefine educational objectives Redistribute health care investments Readjust our Anthropocentric worldview Dr Philippe Wuyts - Burnout Humanity - ICAAD London 6th of May 2019 3. Societal proposals
- 86. Burnout Humanity From Excess to Exhaustion Dr Philippe Wuyts MD MBA Psychiatrist www.philippewuyts.com ICAAD London 6-5-19
- 87. References Dr Philippe Wuyts - Burnout Humanity - ICAAD London 6th of May 2019
- 88. Dr Philippe Wuyts - Burnout Humanity - ICAAD London 6th of May 2019The centre of Biological Diversity
Hinweis der Redaktion
- Thank you all for attending here today Very honoured to be here back in London. I lived and worked here many years ago, as a clinical researcher at the Institute of Psychiatry, Psychology and Neuroscience, Kingâs College. A time I am very fond of remembering. Before I overwhelm you with my far-reaching and cataclysmic ideas about burnout, I would like to express my gratitude to Sam and Christophe from ICAAD for inviting me here today, again. This burnout journey took me from Paris to Cape Cod and now to London, thanks to them. Today talk about BURNOUT - a known in the general press - but controversial topic in the world of psychiatry. I will try to tell a story, rather than give you a dry summary of some research data and numbers - but a look at the many complex interacting perspectives on Burnout pathology as a clinician affecting the individual, but also how it has become a systemic disorder in modern society. To Understand what it is⊠and if it can be prevented/cured? Climate Change Global Warming Global Heating ⊠Global Burning
- Thank you all for attending here today Very honoured to be here back in London. I lived and worked here many years ago, as a clinical researcher at the Institute of Psychiatry, Psychology and Neuroscience, Kingâs College. A time I am very fond of remembering. Before I overwhelm you with my far-reaching and cataclysmic ideas about burnout, I would like to express my gratitude to Sam and Christophe from ICAAD for inviting me here today, again. This burnout journey took me from Paris to Cape Cod and now to London, thanks to them. Today talk about BURNOUT - a known in the general press - but controversial topic in the world of psychiatry. I will try to tell a story, rather than give you a dry summary of some research data and numbers - but a look at the many complex interacting perspectives on Burnout pathology as a clinician affecting the individual, but also how it has become a systemic disorder in modern society. To Understand what it is⊠and if it can be prevented/cured? Climate Change Global Warming Global Heating ⊠Global Burning
- When I was a resident in psychiatry, I thought like so many, that there were people with mental illness and there were normal people. That seems to be the common understanding between psychiatrists, doctors and the general public. With important genetic factors discovered for many major mental illness (while knowing that psychiatric patients have fewer children than the general population) and with better treatments available you would assume mental illness would become less prevalent over time. THE OPPOSITE IS TRUE! How is that possible? Over the last decades it seems that mental health disorders become more and more prevalent: More people are consulting mental health professionals than ever, rates of anxiety disorders, addiction (the OPIOID crisis), deaths due to overdose and suicides are soaring⊠Burnout wasnât even a real thing 20-30 years ago, and now it seems itâs a pandemic. There is even a âburnout generationâ
- It's a strange thing really whatâs happening in our world: there is less poverty, less war in this world. There is more comfort and wealth, better health care, higher life-expectancy, we have all the entertainment and leisure options in this world at our finger tips. We have vast knowledge, we have smart computers, smart phones. We have technology, robots and automation. Economist in the early 20th century predicted weâd only have to work 15h per week! (of course everybody knows you should never listen to economists) Yet we feel too busy to enjoy anything, too busy to rest and sleep properly. And many of us are doing jobs for 60h a week or more that we donât like, and even find meaningless and pointless. So instead of looking at suffering individuals, organs, physiology and symptoms, as doctors tend to do, we should be looking at the world we live in and understand how it affects the individual. What if the real issue is not that these separate conditions are increasing in prevalence, but they are all somehow linked to a wider and deeper problem in western society?? That something I would like to call âBurnout Humanityâ -> NOW Look at this!!
- Until now NO officially accepted DEFINITION nor VALID INSTRUMENT for the differential diagnosis of burnout syndrome. And there are NO CONTROLLED TRIALS for the treatment of burnout.  In the ICD-10 Burnout is coded Z73.0 and defined as a state of vital exhaustion. In medical literature its existence as a distinguishable diagnosis is under debate. Is it different from âDepressionâ or âsecondary stress syndromeâ or âCompassion Fatigueâ??? So letâs use the following âworking conditionâ for now.
- A quick overview - to help you understand the structure of the talk today: Global Phenomenon (slide 9-23) A historical perspective and definition (24-34) Aetiology and Pathogenesis
- Obviously these numbers may be debatable. And in order to really understand their value weâd need to look into the research methodology. But here I just wanted to raise a flag to you⊠In fact, presenteeism appears to be a much costlier problem than its productivity-reducing counterpart, absenteeism (HBR 2004)
- A Cascade!
- A literature Review of several studies in medical residents in the US looking into Burnout prevalence
- OK the numbers are really low.
- A pan European STUDY conducted by the EFPT in 22 countries into BURNOUT Prevalence in psychiatry trainees.
- Total sample of almost 2000 out of over 7000 trainees. Of course keep in my mind these are surveys - self informed!
- More than 15000 respondents (clinicians in US)
- More Numbers?
- SLIDE 20 obviously physician suicide may be linked to other factors than burnout, but surely high rates of burnout and suicide are not completely uncorrelated⊠So whatâs going on? Letâs look at the historical perspective
- The first mentioning of an individual suffering âburnoutâ dates back to the Bible (that is the real Bible) In the Old Testament, in Chapter 18 of Book 1 âthe prophet Elijah, bold and courageous, was victoriously facing all kinds of odds. He experienced Godâs supernatural strength to face extraordinary challenges of famine and draught.â It states further that âthe hand of the Lord was on Elijah.â But then in chapter 19, after Elijah faced misfortune and felt judged and due to fear of the crowds had to flee, he had become fearful, exhausted, depressed, and wanting to dieâŠ
- A more recent literary figure is Query in Graham Greeneâs a Burnt-out case. He arrives anonymously at a Congo leper village, where he is diagnosed as the mental equivalent of a 'burnt-out case', a leper mutilated by disease and amputation.â It said: Query falls victim of a terrible attack of indifference: he no longer finds meaning in art or pleasure in life. â
- The first notion of Burnout in scientific literature dates back to 1974, when Herbert Freudenberger, a psychiatrist working at an outpatient clinic for ADDICTION in NYC (so be warned!) He diagnosed himself and members of his staff as being burnout after he had been working 20h days for months and had become not only exhausted, but cynical and disengaged from his patients and staff. According to Freudenberger burnout was the end point of a cascade in which several behaviours and symptoms would increasingly present themselves over the course of a given time.
- He described 12 separated phases each burnout individual goes through before full burnout pathology presents itself: - The Compulsion to Prove Oneself: demonstrating oneâs worth obsessively; - Working Harder: the inability to switch off. - Neglecting Needs: erratic sleeping, disrupted eating patterns and a lack of social interaction. - Displacement of Conflicts: problems are dismissed. The individual may feel threatened, panicky, and agitated. - Revision of Values: Values are skewed, friends and family are dismissed, hobbies seen as irrelevant. Work becomes the only focus. - Denial of Emerging Problems: intolerance and agression. Social contacts harden; First signs of cynicism. - Withdrawal: social life becomes very small or even nonexistent. The need to feel relief from stress strengthens, often with the use of alcohol/drugs. - Odd Behavioral Changes: friends and family become increasingly concerned. - Depersonalization: seeing neither self nor others as valuable, and no longer perceive own needs. According to FREUDENBERGER a Defense Mechanism?? - Inner Emptiness: feeling empty inside and to overcome this an increase in maladaptive behaviours such as overeating, promiscuity, alcohol, or drug use. - Depression: feeling lost and unsure, exhausted. The future starts to feel bleak and threatening. - Burnout Syndrome
- The first major studies into the symptom dimensions of Burnout were conducted by Christina Maslach (UC Berkeley) who was the first to define burnout as a clinical disorder, defining the psychopathology along the following 3 axes: Exhaustion, depersonalisation and decreased personal accomplishments. During subsequent research she developed âThe Maslach Burnout Inventory (MBI)â, a self-administered questionnaire scored according to their incidence and which is now the standard for burnout diagnosis.
- MBI Items
- So there are a whole range of experiences along those 3 axes that people rate high on the MBI when asked. BUT when we look at the general symptomatology that people with BURNOUT Exhibits, it goes way beyond exhaustion, cynicism and lack of personal accomplishment: End point of a cascade: Here we see how symptoms arise on several levels: Psychological Physical Social and Behavioural Occupational AND existential
- So there are a whole range of experiences along those 3 axes that people rate high on the MBI when asked. BUT when we look at the general symptomatology that people with BURNOUT Exhibits, it goes way beyond exhaustion, cynicism and lack of personal accomplishment: End point of a cascade: Here we see how symptoms arise on several levels: Psychological Physical Social and Behavioural Occupational AND existential
- Doctors like to know about aetiology and pathogenesis aetiology = the cause, set of causes, or manner of causation of a disease or condition or injury. pathophysiology = the disordered physiological processes associated with disease. One of the main reasons why burnout is not classified in DSM-V is that itâs so hard to clearly define its aetiology and pathophysiology. BUT Letâs TRY!
- This slide underlines the importance of how several dimensions interact and contribute to burnout development.
- Commonly accepted today that Burnout is a result of an interplay between personality features (the disposition) AND environmental factors (the situation) over the course of TIME
- Commonly accepted today that Burnout is a result of an interplay between personality features (predisposition) AND environmental factors (the situation) over the course of TIME
- !!!!!!! The other day, gave an interview with CIR and as I discussed the typical personality features of people at risk of burnout, the interviewer asked: So is being a workaholic an early sign of burnout? AND Yes it is! âWorkaholics are individuals addicted to their workâ: There is a compulsivity to this behaviour, just like in other addictionsâ (seen as more pathological) For workaholics: they are soo driven, donât know where to stop. The border between âprofessional dedicationâ AND âprofessional identificationâ has become blurry. They BECOME their profession, their lifeâs meaning becomes derived from their professional status. (they hide behind excuses, often acceptable!!, unlike cocaine/heroine addictsâŠ) Furthermore, in people developing burnout we often see other typical features of addictive behaviour: in order to keep going, they (ab)use coffee! (ok just a mild stimulant), or Redbull, or ritaline/vyvanse/aderal (students) or ⊠cocaine (widespread in white collar workers) to Focus and PERFORM and alcohol/sleeping pills/benzodiazepines/opioids to NUMB themselves and SLEEP (uppers and downers)⊠As such obvious link with substance abuse, dependence and addiction in GENERAL
- The rhythm of this work is relentless. Every stage of the process has been optimised, cutting no slack, sparing zero downtime⊠There is no respite to claim between decisions or transitions, because the job is one-dimensional and singular. You pack. Data is absolutely central to this efficiency. Amazon gathers information on virtually everything its workers doâââfrom their pack rate to downtimeâââthen pits workers against each other on the basis of these metrics. The company is always looking for ways to gather more informationâŠ
- not only in blue collar workers, but in white collar workers even more the issue: higher class, higher earners today work more than lower income counterparts. Many high income earners forgo vacations
- Important Factorâs in todayâs work environment!
- An excellent example from a clinical environment
- So now we have looked at internal features and external features, these are useful at a descriptive level, but are insufficient to understand aetiology and pathophysiology, so letâs look further. This is an excellent work for those interested in the effects of todayâs work environment! As Jeffrey Pfeffer points out: The problem lies to a large extent in the âWORKPLACEâ, refers rightly to STRESS
- Misconceptions about STRESS - so a few slides!
- General Adaptation Syndrome Start of from a point of relative homeostasis (the organism is at rest, in balance) He conceptualised the physiology of stress defining 3 separate states: THE STRESSOR OCCURS => - An initial alarm state
- Followed by a phase in which a set of responses ("general adaptation syndrome") marked by increased âstress resistanceâ and (stress resistance state) âWhat doesnât kill you, makes you strongerâ
- Finally followed by a pathological phase with decreased stress resistance as a result from ongoing, unrelieved stress. (the exhaustion state)
- STRESS and PERFORMANCE: A in a state of peaceful quiet restfulness âwe are not performingâ - depending on the environment: âI feel calm and contentâ OR âI feel boredâ
- So STRESS is Good?! Or is it BAD?
- !!!!! So it depends HOW MUCH STRESS and FOR HOW LONG??? Can we adapt? Can we recover? So patients arrive at the office and they are puzzled that they are in this state of exhaustion even though they tell me they work form morning till evening for years, late at night, until midnight, even in the middle of the night, or early morning, they are âONâ and then they canât sleep⊠even though so tired!! No holidays, no time off, no peaceful Sundays⊠And so I ask them how they think professional athletes spend their time during one 24h period? 4-6h of exercise maximum, the rest âactive recoveryâ!!!! Does the brain not need rest?
- What is stress?? A picture of the brain and spinal cord There are 2 sides to the autonomous nervous system. The system that is âkeeping us aliveâ. It regulates all are bodily functions for us, INDEPENDENTLY!! We donât actively think to have our heart beat, our pancreas generate enzymes, our lungs breathe etc. RIGHT
- Fight and Flight VS Rest and Digest Itâs a WAVE - Like The SEA We come from the sea, we are 60-70% sea water!
- So when weâre in FIGHT or FLIGHT mode and experience a high level of STRESS - what happens to our body? -CIRCADIAN Disruption
- 2 INFLAMMATION
- GLYCEMIC DYSREGULATION
- PERCEIVED STRESS - mental level
- So the problem with STRESS is that itâs EVERYWHERE at the same time. Itâs hard to define the pathophysiology and aetiology of burnout in simple and singular pathways
- This is the simple explanation of burnout: Some Stress is good: makes us resilient. The key is to introduce recuperation - restoration âDOWN Timeâ Then it becomes excessive and starts accumulating and causes initial problems Until finally it becomes chronic, causes serious health concerns and Eventually Burnout Simply Put: people work too hard, it causes them too much stress, the develop symptoms and over time they develop burnout⊠So are we burnout from working too hard? And stressing too much?
- TRY out from here onwards!! But why has burnout become so prevalent recently? What drives people to exert themselves to such extremes that stress builds up endlessly AND becomes chronic? Why do people not stop before they reach that state of accumulated and chronic stress?
- So it refers to an existential/spiritual issue âan erosion in value, dignity, spirit and willâ Something more profound is happeningâŠ
- 3 different dimensions: the individual - the work environment - THE âSystemâ together form a toxic stress generating and reinforcing mechanism ====> leads to BURNOUT Burnout is a systemic disease, it exists on a nervous system level, a full body physical level, a psychological level, an spiritual-existential level AND a Systemic Societal Level. All of these levels interact and generate the very complex pathology of BURNOUT. That make it simultaneously close to undefinable and evasive AND systemic and Pervasive. Here I go beyond the realm of what a typical talk on mental health would include. The next few slides I would like to touch upon certain aspects of the modern world that we live in and in my opinion have contributed to the current burnout pandemicâŠ
- a mind-boggling attempt to explain the situation in Afghanistan. When we understand that slide, we'll have won the war,' General Stanley McChrystal, the US and NATO force commander, remarked
- The FIRST Over the last few decades, the world has changed dramatically: We have entered the digital or information age: the immediate availability of information the globalized world, the dissolution of boundaries, norms, values, religion. We live in a VUCA world The environment demands you TO: Volatility - React to ongoing changes that are unpredictable and out of your control Uncertainty - React without certainty The Environment is Complexity - Dynamic with many interdependencies - Clarity Ambiguity - Unfamiliar, outside your expertise - Agility
- Secondly: âCAPITALISMâ - rising inequality and unmatched wealth and consumerism âWe need a job, we need to make money, we need to produce and consume.â How well off a nation is, is measured in âUnemployment ratesâ and âGDPâ and âJob Growthâ Thatâs what you hear in the news, every day! TECHNOLOGY seems to accentuate and reinforce the principles of capitalism further. Through TV and now social media, corporations can now reach millions of potential customers in seconds. Burnout is a disorder that exists at the cross road between the natural world and the digital world
- Secondly: âCAPITALISMâ - rising inequality and unmatched wealth and consumerism âWe need a job, we need to make money, we need to produce and consume.â How well off a nation is, is measured in âUnemployment ratesâ and âGDPâ and âJob Growthâ Thatâs what you hear in the news, every day! TECHNOLOGY seems to accentuate and reinforce the principles of capitalism further. Through TV and now social media, corporations can now reach millions of potential customers in seconds. Burnout is a disorder that exists at the cross road between the natural world and the digital world
- Third, there is âMERITOCRACYâ: A meritocratic society is a society in which people get what they deserve. There is this belief that in a competitive market place those with talent and hard work will âmake itâ, Simultaneously suggesting that those who donât did not deserve it. And so the ones who do hit themselves on the chest (self-righteousness and eventually injustice) âlook at me, I am successful, because I am amazingâ. âYou, loser, you should try harderâ And so from a very young age, this logic is pushed onto children in schools: study hard, work hard, compete, and you will be successful. And so modern man develops an insatiable drive towards self-accomplishment. Whereas before this drive served a simple purpose: to generate income or improve prosperity, nowadays it has become the foundation of a meaningful life in itself. âI am my own lifeâs projectâ. Today we look at our I Phone at our followers on Instagram: âthe glorification of MEâ
- One manâs existence becomes objectified as a project of self-idealisation through oneâs profession. So we study for years, to graduate from a top school, so we can get a serious job, work HARD, LONG HOURS, for employers that donât give us autonomy and respect, to make a career, and more money, so that we can consume goods, (that make us fat and lazy). All of which generates excessive and eventually chronic STRESS, but we feel we have to, as we identify ourselves and generate meaning in life. âThe absence of the relation to the other causes âa crisis of gratificationâ, leaving the achievement subject stuck in self-related performing and narcissistic self-absorptionâ
- Even âsecondary Bullshit jobsâ WHILE we feel that our job is pointless, meaningless, a scam??? So if our identity is strongly defined by our profession, stressing us out through its RELENTLESS pace and constant pressure for progress, but seeming intrinsically meaningless, then what do we fight for and, even more importantly, who are we? BURNOUT is fundamental crisis in EXISTENCE
- Like Icarus, modern man is told to fly as high as possible⊠But if you fly to close to the sun, your wings will melt and you will CRASH AND BURN Modern man is infused of the idea that he/she needs to make this life worthwhile, jam pack it full with wealth, success and experiences. Be your BEST SELF! Every minute counts, make the best of it! The sky is the limit! THE AMERICAN DREAM (the land of opportunity AND of burnout) The terrible lesson of the man in the white house. The pervasive destruction of Narcissism.
- Pascal Chabotâs Burnout, published in 2013, is a ground breaking work. If you are to read one book on Burn-out, it should probably be this one. Itâs a philosophical account on the burnout epidemic that captures very well itâs systemic character and the underlying causes in postmodern society for its increasing pervasiveness
- What can we do?
- Check other references in library !!
- âautonomy is the amount of discretion to determine what to do and how to do itâ âJobs that provide individuals more autonomy and control serve to increase their motivation, job satisfaction and performance - and also make individuals healthier and live longer.â (J Pfeffer)
- The modern world is obsessed with : Growth - Efficiency - Productivity - Optimisation This one is obvious. We only have this one planet. It gave us life. We need to respect, cherish it and stop this exploitation. The USA spends 17% of GDP on health care, but has very average results on international health comparisons. Too much money is wasted on treatment in the last 6 months of life - to fill the pockets of pharma company shareholders - where it could be spent to help those really in needs: children, young people with mental health issues and PREVENTION!! We human beings act too much like we think we own this planet. As if itâs ours to use, to exploit as we please. BUT thatâs not right. We are a species given life on this earth, we are part of it. We need to live in harmony with it. âNatureâ is not something out thereâ. Itâs who we are and we should embrace and take care of it. As result of being too far estranged from our core being
- This one is obvious. We only have this one planet. It gave us life. We need to respect, cherish it and stop this exploitation. The USA spends 17% of GDP on health care, but has very average results on international health comparisons. Too much money is wasted on treatment in the last 6 months of life - to fill the pockets of pharma company shareholders - where it could be spent to help those really in needs: children, young people with mental health issues and PREVENTION!! We human beings act too much like we think we own this planet. As if itâs ours to use, to exploit as we please. BUT thatâs not right. We are a species given life on this earth, we are part of it. We need to live in harmony with it. âNatureâ is not something out thereâ. Itâs who we are and we should embrace and take care of it. As result of being too far estranged from our core being
- As Hippocrates, the founder of medicine said, âeverything in excess is opposed to natureâ
- This one is obvious. We only have this one planet. It gave us life. We need to respect, cherish it and stop its extreme exploitation. The USA spends 17% of GDP on health care, but has very average results on international health comparisons. Too much money is wasted on treatment in the last 6 months of life - to fill the pockets of pharma company shareholders - where it could be spent to help those really in needs: children, young people with mental health issues and PREVENTION!! We human beings act too much like we think we own this planet. As if itâs ours to use, to exploit as we please. BUT thatâs not right. We are a species given life on this earth, we are part of it. We need to live in harmony with it. âNatureâ is not something out thereâ. Itâs who we are and we should embrace and take care of it. As result of being too far estranged from our core being