About Burnout
According to the latest revision of the International Classification of Diseases (ICD-11): Burn-out is a syndrome conceptualized as resulting from chronic workplace stress that has not been successfully managed. It is characterized by three dimensions:
feelings of energy depletion or exhaustion
increased mental distance from one’s job, or feelings of negativism or cynicism related to one's job
reduced professional efficacy
There is growing body of research in both the field of psychology and field of neurology that suggests burnout is caused by affective empathy and “absorbing” the stress of those around you, causing an initial state of sympathetic (“fight or flight”) nervous system activation, leading to a final state of parasympathetic (“shut down”) nervous system dominance with symptoms of fatigue and disconnection from others (Handbook of Clinical Neurology, 2021). Viscerally feeling the pain and suffering of others activates brain areas of first-hand experiencing of pain and floods the helper’s body with stress hormones. This cycle of over-empathizing with clients and chronic release of stress neurotransmitters and hormones in response to first-hand experiencing of pain leads to nervous system dysregulation and symptoms of burnout. The body naturally withdraws from others, the source of stress, by dehumanizing them. The burned-out helper will start seeing people as objects as a defense mechanism and experience depersonalization (impersonal and callous attitude towards others and work). As the nervous system struggles to maintain a high level of activation over a period of time and trends toward hypo-reactivity towards later stages, energy levels are increasingly low, and the helper becomes unable to stay engaged in their work.
To prevent and treat burnout, high stress hormone release in response to client suffering must be prevented. This can be achieved by compassion training with the goal of maintaining the boundary between the helper and client so that the helper experiences deep caring and love and desire to help in response to the client’s suffering rather than the pain of the client in their own body (Erikkson et. al. 2018, Watts et al., 2021). Whereas unmanaged affective empathy (emotion sharing) leads to burnout, compassion alleviates symptoms of burnout and encourages pro-social behaviors of bonding and moving towards the sufferer. Although the terms empathy and compassion are often used interchangeably in colloquial language, in scientific research empathy is predominantly used to describe “emotion sharing” or “taking on someone else’s emotional state”. Empathy is often used in the context of pain and is associated with first-hand experiencing of someone else’s pain so that your nervous system mirrors theirs. In contrast, compassion refers to positive emotions of kindness and warmth, releases hormones associated with bonding, and activates brain areas of pro-social behavior, meaning that it is associated with a motivation to help someone and move towards them in their suffering.
Empathy is often promoted as an important trait in helping professions or in a Christian context, and to some extend that is true! To care for and alleviate those in pain we need to understand their situation. However, there is really nothing virtuous about empathy as it is a subconscious process mediated by our in-built mirroring mechanism that allows humans and animals to become automatically emotionally attuned with those around us (Neuronal Correlates of Empathy, 2018). On the other hand, compassion is a purposeful, cognitive choice of reaching out in love and warmth to someone in pain. From a biological perspective, compassion begins by recognizing others’ pain and maybe experiencing a twinge of that pain in yourself (affective empathy), but instead of dwelling on the pain you are feeling in response to theirs and letting yourself be overcome by emotion sharing, compassion involves a transition into a positive mindset of love, caring, and motivation to alleviate suffering. The goal in compassion training is to be compassionate and calm in the face of suffering. This prioritization of compassion is Biblical and aligns with Jesus’ acts to alleviate suffering and His demonstration of love and care to those He ministered to.