Individualizing treatment techniques for burnout syndrome
July 31, 2017
by Dr. Nancy Gahles, DC, CCH, RSHom(NA), OIM Feeling "burned out"—exhausted, spent, running on empty— manifests in irritability. Your patient may feel irritable in their moods, in their interactions with others, and with themselves. They may experience anger over small issues, flare ups of temper, anxiety, apathy, indifference, lassitude, and depression. Feelings of wanting to cry or crying easily; difficulty concentrating; forgetfulness; confusion; and feeling overwhelmed or rushed are symptoms that your patient is burned out. Irritability manifests in your body as muscle aches and spasms in the neck, shoulders, back, legs; tightness in the chest; heart palpitations; digestive issues (GERD); changes in appetite; constipation or diarrhea; sleep problems; nervous habits such as nail biting and tongue clucking; dry mouth or throat; high blood pressure; excessive sweating; fatigue; grinding teeth; headache; frequently sick; dizziness; and adrenal/thyroid issues. Your issues are in your tissues. Your body speaks the language that you may not be trained to hear or to interpret. You may know that your body and mind are telling you that you are exhausted, burned out, but you may not be able to or willing to listen or to act upon a solution. It may be that the circumstances in your life that contribute to burn out appear to be unchangeable. You may think that you are trapped in a lifestyle that is simply, your lot in life. Who is at risk for burnout syndrome? Caregivers are at the top of my list. Caregivers range from parents to professional caregivers and the “in between” hybrid of people who have dual responsibility of caring for their immediate family and their parents—the “sandwich” generation. Caring for members of the family at home who require constant attention can breed anger, resentment, guilt, and feelings of low self-esteem and despair. Anxiety tops the list due to the constant demands of being the custodian to someone who desperately needs you. Compassion fatigue and vicarious traumatization are unique forms of burnout that affect individuals in caregiving roles bearing the responsibility, emotionally and physically, for the life and well being of a patient, partner, child, or parent. Burnout syndrome is a well known phenomenon in adolescents who are to striving or driven to achieve, to meet often unrealistic expectations of their own or expectations foisted upon them by parents or society. Dropping out of college is a symptom of burnout when students have been pushed or over-worked to the point where they simply cannot function anymore in that environment. Burnout syndrome is manifest in our young adults entering the workforce where 12 hour days and incongruent remuneration is the standard. Couple that with two to four hours of commuting time and the resultant disruption in work-life balance and you have the perfect recipe for anger soup. Overachievers, those people who go beyond the call of duty in order to be “good enough,” or please people, are intrinsically at risk for burnout. Solutions to burnout and skillful strategies to prevent and manage situations that could lead to burnout are at hand. Each person’s situation needs to be assessed on its own merits. The gift of success is in the understanding of the unique aspects of each case. In my experience, the most successful strategies lie in evaluating the person in the burnout phase. What makes you tick? What makes you sick? Standard burnout tests offer information to proceed with. Consultation on the emotional, mental, and physical symptoms must be undertaken to remedy the underlying dysregulation of the whole system. We, as humans, are adaptive network systems. We have the capacity to adapt to interventions that are able to restore us to right function. Interventions from the fields of nanomedicine, nutrition, exercise, lifestyle, and behavioral modifications, mindfulness meditation, and yoga are most effective strategies. Building spiritual capital is extremely importan, as research shows that meaning and purpose in life predicts resilience under stress. In his book, How Can I Help?, author Ram Dass says, “We can burn up, but we can’t burn out if we keep our spiritual boundaries intact." Compassion, self-compassion, selective attention, and loving-kindness are skill sets that need to be understood, cultivated and tended to grow your garden of well-being. Grace under pressure is a character trait that serves you and the ones you care for. It is a learned behavior. It is a phenomenon that radiates to others. It is a virtue and a presence of light, the light that burns brightly but does not burn out. In the words of the illustrious poet William Blake: Tiger, tiger, burning bright,In the forests of the night,What immortal hand or eyeCould frame thy fearful symmetry?Skillful strategies are at hand for you to burn brightly, white hot. To learn to simmer down, to tend to the embers below. Cultivate techniques that allow you to keep the heart light, pilot light, and eternal flame alive while you go about the business of being you. Practicing the art of strategically individualizing techniques that fit the case of your own or your client’s needs will be the subject of an experiential workshop scheduled to be presented at the upcoming Integrative Health Symposium in February 2018.
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