Burnout and Self Care: A Process in Helping
by David M. Papia, LCSW
Is burnout an endpoint or a process? If it is an endpoint, are professional helpers at risk for that outcome while having limited ability to do anything about it? If it is a process, doesn’t that suggest we can have control over burnout?
What is this notion of self care? Is it a New Age term that we have yet to embrace collectively? Or is self care an established notion in the helping professions? Furthermore, as professionals, we want to know what burnout and self care have to do with being a good professional helper and where our responsibilities lie in relation to these issues.
Introduction
The words “burnout” and “self care” have been catchy and useful but might need linguistic assistance. We sometimes say we are burned out. This term is static and suggests immobility. The best term may be “burning out.” When we are aware that we are burning out, when we can step back and see our situation more objectively, we begin to see how burning out truly is a process. Often, we say we need to take better care of our selves. The process a professional helper undergoes may simply be referred to as “caring for our selves.”
When viewed this way, we can begin to understand that burnout and self care are fluid experiences, hardly ever static, and for the professional helper this implies we can have control over these processes. As professionals, we need to address these terms and the issues surrounding them. My intention is to produce clarity and support for the sake of the professional helper and, in particular, the profession of social work—a profession in which I have been intimately involved for 30 years. I have come to realize how very important it is to be knowledgeable, preventive, and proactive regarding burnout and self care.
The Literature on Burnout and Self care
The literature on burnout has spanned nearly 40 years. Freudenberger is widely credited to be the first to apply the term (Thompson, 2009; Smullens, 2012; DeSilva, Hewage, & Fonseka, 2009; Waugh & Judd, 2003). He referred to burnout as having the experiences of feeling like a failure, feeling worn out, and becoming exhausted (Thompson, 2009).
Other early authors have had similar views on the subject of helping and burnout. In Edelwich and Brodsky’s study (as cited in DeSilva, Hewage, & Fonseka, 2009), the authors state that the professional feels “a progressive loss of idealism, energy, and purpose.” In Pines and Aronson’s study (as cited in Waugh and Judd, 2003), the authors state the professional feels “a state of physical, emotional, and mental exhaustion.” Maslach seems to be the most widely acknowledged contributor to thinking about burnout. In her work and research (as cited in the National Association of Social Workers NASW—Professional Self Care policy, 2009), she states that burnout is “a syndrome of emotional exhaustion, depersonalization, and reduced personal accomplishment that can occur among individuals who do ‘people-work’ of some kind.”
With this historical view of burnout, we could easily be led to the sense that burnout is a downward spiraling experience that brings us to an unfortunate end. What I see in these descriptions is that burnout equates, in functional terms, to the professional having less capacity to sustain and less capacity to give.
Self care is not new to our profession. In Poulin and Walter’s study about burnout and self care (as cited in Smullens, 2012), they address how burnout can be reversed and that self care is “a process that can be engaged to restore balance in our personal and professional lives.” Maran Dale (2008, November), in her article, “The Profession Must Prioritize Self Care,” addresses the individual social worker’s responsibility and the responsibility of educational settings and agencies to provide healthy work environments. Tracy Whitaker (as cited in Dale, 2008), said, “We learned that it was not the clients themselves who were causing the major portion of the stress, but the work environment itself,” and, “The primary stress social workers face is that they don’t have enough time to do their jobs, and related to that, have too heavy a workload,” and “This was true across practice areas.”
The NASW Policy Statement on Professional Self Care, approved by the NASW Delegate Assembly in August 2008, is a gift to our social work profession, as well as to other helping professions. This Policy Statement addresses how “the practice of self care” is not only the way to respond to our occupational stressors, but it is also “a core essential component” to our competent and effective ongoing professional practice (2009). As this policy statement describes self care and articulates the case for the vital importance that self care has for the professional and the profession of social work, and as this statement describes burnout and its effect on the professional, it challenges all of us to respond and to move forward.
Burnout in Social Work
Our social work profession is noble. This is a very special career path. We get to participate in important matters in people’s lives. We learn about ourselves, about others, and about humanity. We engage in giving and receiving, and we engage in relationships that further who we are and further those to whom we attend. However, our profession comes with many significant challenges and occupational hazards that threaten to weaken our profession and the resolve of the professional social worker.
We know that our profession has become deeply entrenched in managed care practices, bureaucracies and governing bodies determining our daily work conditions, very high caseloads, low salaries, and a profound amount of accountability expectations. These realities and conditions can and sometimes do weigh very heavily. It is easy to recognize the feelings and sentiment of doubt and questioning: Should I continue in this profession? Am I enjoying my job? How can I sustain? We might even wonder if someone should consider entering our profession. As a father whose daughter has recently gone off to college and has an interest in social work, I notice myself being “on the fence” about her interest in our field.
We also have the stressors and realities of doing clinical work day after day. Smullens (2012) articulates the stressors, psychological issues, and “sheer exhaustion” associated with clinical work in describing and defining burnout. Smullens expands her discussion about burnout when she addresses the “attendant syndromes” of vicarious traumatization, compassion fatigue, and secondary traumatic stress—and their resulting effect on the social worker. It is commonly known that doing clinical work, and especially work with very challenging and traumatized populations, presents risks for experiencing burnout. Suffice it to say, the experience of burnout as an occupational hazard in our profession has its roots in clinical, organizational, and systematic experiences we face daily.
Self Care in Social Work
There are literally hundreds of self care practices available to the professional helper. A Self Care Assessment, provided by Saakvitne, Pearlman, & Staff (adapted by Lisa D. Butler, Ph.D., University of Buffalo School of Social Work) details a self care worksheet that is divided into six life areas: physical, psychological, emotional, spiritual, relationships, and workplace or professional. This helps us to see how ideas about self care can be presented in various forms, giving us a number of ways to view and consider different practices.
The Columbia University School of Social Work, as discussed in its “News and Events” in November 2012, offered two experiential self care days for social work students, meant to enhance the lives of the students and help them to define what self care is for them and to learn to practice self care. As a result, the school’s students began to better understand self care and then include that in their daily functioning.
When self care practices are examined, understood, and put into practice, we see they all—no matter what form they come in—essentially give us the same outcomes: we become rejuvenated, energized, inspired, healed, restored, and happier. In so doing, we become increasingly capable to continue to serve others, to give to others, to engage in giving and receiving in a manner and to the degree that honors our profession and the role of a professional helper. Self care practices improve and enhance our human being-ness and our human performance. They help our heart to remain open, our mind to remain clear, and our compassion to come forth. The social work profession, as with other helping professions, requires us to know our selves and effectively use our selves in our professional capacities. Caring for our selves will help us to become more of our selves closer to our fullest potential.
Our Challenge: The Time Has Come
Victor Hugo has been widely quoted as saying, “There is one thing stronger than all the armies in the world and that is an idea whose time has come” (Kolsbun & Sweeney 2008, pp. 20-21). The idea I wish to put forth is the following: Because burnout (burning out) and self care (caring for our self) are two of the most significant issues we will encounter during our careers, it is imperative that we be well informed, that we do respond, and that our response is wise and effective. I believe that by changing our viewing and changing our doing relative to burnout and self care, this will open up immeasurable possibilities for growth and will support our response that is needed.
Viewing: When we are viewing burnout (burning out) and self care (caring for our selves) as ongoing processes, this offers us a real sensibility that these issues are under our control; something we can manage and develop mastery over. Additionally, defining these terms in a way that captures their functional nature is also to our advantage. Burning out and caring for our self are active and dynamic entities that do not exist in isolation. Their definitions need to make sense in our world of social work, where our primary mode of functioning is through the relationship. To that end, I offer the following definitions.
Burnout: Whereas burnout (burning out) happens in relationships, and it is influenced by conditions, situations, experiences, and our attitudes, the process of burning out leaves us feeling depleted and having less capacity to give to and connect with others.
Self care: The effects and outcomes of self care (caring for our selves) are what we bring to our relationships. The process of caring for our selves leaves us feeling enriched and having more capacity to give to and connect with others. I believe that viewing burnout and self care in these ways guides us to become ready to act accordingly, and differently, when needed.
Doing: As professional helpers, we want the situations and outcomes to improve for those we serve. We want this for ourselves, as well. To be effective and to make these improvements, we need to be conscious and active participants in the ongoing processes of burning out and caring for our self. We know we will continue to be confronted with risks for burning out. And we know that caring for our self will help us to overcome those situations. I firmly believe that with understanding burning out and caring for our self to be ongoing processes, and with knowing we can effectively participate in these processes, we can bring about positive change. Participating in these ongoing processes will be a matter of choices we make during our careers. To engage in properly addressing the challenges we face is to become wise and learned professionals. And to engage in caring for our selves is a vitally important career decision—one that will benefit us every step along our journeys as helping professionals.
References
Columbia University School of Social Work. (2012, November 9, 21). Retrieved from http://socialwork.columbia.edu/news-events/how-social-work-students-define-and-practice-self-care.
Dale, M. (2008, November). The profession must prioritize self care. NASW News, National Association of Social Workers.
DeSilva, P. V., Hewage, C. G., & Fonseka, P. (2009, September). Burnout: an emerging occupational health problem. Galle Medical Journal, 14 (1), 52-55.
Kolsbun, K., & Sweeney, M. (2008). Peace: the biography of a symbol. Washington, DC.: National Geographic Society.
National Association of Social Workers. (2009). Professional self care policy. In Social work speaks: National Association of Social Workers policy statements 2009-2012 (8th ed., pp. 268-272). Washington, DC.: NASW Press.
Saakvitne, Pearlman, & staff of TSI/CAAP. (1996). Transforming the Pain: A workbook on vicarious traumatization. Norton. Retrieved from http://www.ballarat.edu.au/aasp/student/sds/self_care_assess.shtml and adapted by Lisa D. Butler, Ph.D.
Smullens, S. (2012). What I wish I had known: Burnout and self care in our social work profession. The New Social Worker, 19 (4), 6-9.
Thompson, B. (2009, February 16). Burnout: definition and risks. Retrieved from http://biznik.com/articles.
Waugh, C., & Judd, M. (2003, Spring). Trainer burnout: the syndrome explored. Journal of Career and Technical Education, 19 (2), 47-57.
David M. Papia, LCSW, earned his master’s degree in social work at the University of Buffalo. He is employed at Child and Family Services, a large human service agency in Buffalo, New York, whose roots trace back to the first Charity Organization Society in the United States.