Chapter 6 Supplement Mental Health Needs

In an April 2000 national opinion poll survey of a randomly selected national sample of 1,205 adult women, The Gallup Organization found that women have a wide variety of issues that challenge them as they go about their daily lives. The top seven categories of most concern to women are:

• Economic situation - 26%.

• Family - 22%.

• Health - 15%.

• Stress, managing their time, getting things done, and balancing their lives - 14%.

• Jobs and career - 8%.

• Education and schooling (for both themselves and their children) - 7%.

• Equality, equal opportunity, and discrimination - 4%.

Stress can be defined as an overload/demand state, where individuals are being presented with more information, stimuli, intensity, and immediacy than they can take in or process. Burnout is the end result of chronic stress where, on some level, people start to shut down under the demands being placed on them from the outside world.

Burnout takes place in an environment of competing demands, decreased ability to set personal and work limits, and the sometimes vague sense of not caring so much about the work (or sometimes, anything) anymore. It may start as fatigue stretching out into weeks, which the weekends, holidays, or even vacations do not alleviate. The signs may become more blatant, with increased alcohol or drug use, changes in appetite or food intake, sleep disruptions, or the onset of health problems. In addition, burnout tends to be an isolating experience. An individual is often unaware of the effects of burnout and can only be made aware by the observations of others: co-workers commenting on a change in work habits, family members noting problems occurring in primary relationships, or friends complaining of the individual's unavailability.

Burnout can take any number of forms: behavioral, relational, physical, or affective (feeling-related). Symptoms presenting may include:

• Disillusionment with and a lack of caring for work and, at the same time, an inability to find the means to decrease assigned workloads.

• Feeling numb; few "ups or downs"; an inability to feel anything.

• Decreased desire to socialize or to pursue usual activities outside of work.

• Breakdown in personal relationships; feedback from others that one is not as present or available for others as in times past--minimizing one's contact with the outside world.

• Difficulty modulating affect--finding oneself prone to emotional outbursts that are out of proportion to the given situation.

• Chronic sleep disruptions, ranging from restless, fitful sleep, to nightmares, to early awakenings with one's first thoughts being of the upcoming day's work demands.

• Physical complaints or symptomatology that suggest chronic stress on the various body systems: gastrointestinal upsets, chronic headaches, cardiac problems, breathing difficulties, fatigue, and nonspecific aches and pains.

• Decrease in the meaning or sustaining power of one's usual spiritual, religious, or recreational involvements or practices, in the face of daily problems, and a decreased ability to place work and life problems in a larger, more meaningful context.

• Continually thinking about work (perhaps obsessively) during nonworking hours, even when physically involved with other pursuits--thoughts that involve a continuing round of problems rather than solutions or resolutions.

• Severe mood problems, such as fluctuations or suicidal thinking, may become evident in more serious instances--where maintaining oneself throughout the day is more of a tiring difficulty than a challenge or satisfaction (Goetz, P. 1995).

CHRONIC RESPONSIBILITY SYNDROME

The term "chronic responsibility syndrome" (CRS) describes people who "believe they're responsible for everything because they alone are the only ones who can do it" (White and Menendez 1998).

People who get caught up in CRS are exhausted from their workload. Every time a new project comes along, they are assigned to it because they are dependable, reliable, and responsible. They are the problem-solvers--always coming in to save the day because they know how to get the job done right.

The positive side to CRS is that such individuals are capable of handling the responsibilities and rising to the occasion. The downside is that co-workers and others may see them as the only ones who can do the job and never ask anyone else to do the work. Often, individuals who identify with CRS are afraid to say no to the workload because they are sure they will disappoint someone.

Breaking CRS means getting one's priorities straight. It means learning that being responsible means ensuring that something will get done, but not necessarily personally doing the work. To break CRS, one must let go of the ego of believing he or she is the only one who can get the job done.

According to White and Menendez (1998), there are three things individuals must do to break away from CRS:

1. Say no. One of the biggest blocks is wanting to please other people before pleasing oneself. The reason many individuals say yes is often because they don't want someone else to think badly of them.

2. Delegate and train. One of the reasons people often believe they're the only ones who can do the job is that they've never taken the time to teach anyone else how to do it. They're caught up in the erroneous belief that it will take more time to teach someone else than to do it themselves.

3. Take a sabbatical. People are resourceful; they will find a way to get the job done. The absence of the individual who identifies with CRS can often be exactly what co-workers need to spur them on to greater initiative and a more even and appropriate distribution of workload and tasks.

RECOVERY FROM BURNOUT

The American Psychological Association (1997) describes the process of recovering from burnout as "the Phoenix Phenomenon:"

You can arise Phoenix-like from the ashes of burnout, but it takes time. First of all, you need to rest and relax. Don't take work home. If you're like most, the work won't get done and you'll only feel guilty for being "lazy."

In coming back from burnout, be realistic in your job expectations, aspirations and goals. Whomever you're talking to about your feelings can help you, but be careful. Your readjusted aspirations and goals must be yours, and not somebody else's. Trying to be and do what someone else wants you to be or do is a surefire recipe for continued frustration and burnout.

A final tip--create balance in your life. Invest more of yourself in family and other personal relationships, social activities and hobbies. Spread yourself out so that your job doesn't have such an overpowering influence on your self-esteem and self-confidence.

• An interesting "burnout inventory" specifically for professionals who work in human services can be accessed via the Internet. Practitioners can answer a series of questions related primarily to work-related stress. An overall "burnout score" is provided upon completion of the survey, with four sub-scores provided specific to: emotional exhaustion; detachment/dehumanization of clients; overwhelmed feeling and loss of interest; and general exhaustion. The burnout inventory can be accessed at <http://www.queendom.com/cgi-bin/tests/burnout1.cgi>.

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