Burnt Out
by SaraKay Smullens, MSW, LCSW, DCSW, CGP, CFLE, BCD
(Editor's Note: This article is a follow-up and builds on SaraKay Smullens' previous article titled What I Wish I Had Known: Burnout and Self-Care in Our Social Work Profession.)
In loving, devoted, enduring memory of Dr. Miriam S. Spector—advocate, inspiration, colleague, friend.
As I write this, COVID-19 is terrifying America. Some of us are ill—some extremely so. Family members, colleagues, friends, and neighbors are stricken. We are isolated and warned that the week before us will hold far higher numbers of death, and to prepare for a period as devastating at 9/11. Those not diagnosed feel ill and are not sure how ill we really are. Sleep eludes us. News on television and online increases our terror. Politics, coronavirus, climate change, and violence and murder swirl around in our heads. Our blood pressure and heart rates rise. We crawl back under the covers but cannot rest.
These symptoms are those of another epidemic, one long simmering, which I define as Societal Burnout.This is a state of being in which we are overwhelmed, overburdened, and overloaded by grave, threatening societal problems. It is often marked by a sense of mourning—of profound loss—for what has been lost and what should be. And grave fear about the future. Never in our lifetime have we experienced today’s realities—ones that a client recently described as a “living hell on earth.”
The sudden, shocking August 12, 2019, death of a precious friend, in perfect heath, yet overwhelmed by relentless societal threats, propels me to address the origin, warning signs, and how to address societal burnout in these dangerous, surreal times. Like personal and professional burnout, if unaddressed, societal burnout can be deadly.
The term burnout, non-existent during my graduate work, was coined by psychologist Herbert Freudenberger in 1974. Although the term had not spread to common usage at that time, its symptoms were precisely those that many of us find inherent in social work practice—exhaustion, overload, and depletion—which, if not addressed, lead to dysfunction and beyond. Yet, inside or out of the classroom when I was a student, there was never a discussion of all our profession would ask of us, personally and professionally, and that to insure our health and well-being, the overload inherent in social work practice must be recognized and addressed. Nor was there any mention of the draining, complex impact of societally-induced overload, or societal burnout.
Although in recent years I have used societal burnout as a descriptive term, before Miriam’s death I had not given thought and attention to the importance of framing and highlighting the extraordinary dangers societal burnout poses to social workers, our clients, and beyond. This is the purpose of what follows.
Social work has accurately been described as “an impossible profession.” Day in and day out, we see suffering, making us vulnerable to personal and professional burnout. Further, our work effectiveness has continuously been affected by threatening seeds of societal discord, jeopardizing all we hold dear. Strongholds in American society have, with regularity, turned a blank face to suffering, refusing necessary programs for our clients, viewing kindness and compassion as weakness, holding to a “survival of the fittest” mantra. Tension between this position and a more humane one, documented in the interpretation of our Constitution and resulting law, leads to grave societal tension.
The trauma of 9/11, when previously we believed that geography brought us invulnerability, resulted in societal shock waves, still reverberating, intensifying distrust of “the other,” and fanning the flames of prejudice. The relentlessly fast pace of our technological revolution, accompanied by industrial turmoil, job displacement, anger, and division, escalates this tension, as does loss of American life in war, especially when military direction is questioned.
Today, the illusion of safety is non-existent, both externally and within our borders. No longer are there havens guaranteeing care and shelter. Not even innocent children in their schools or the faithful in their religious communities are safe. Our worst fears are perpetually visible in the backdrop of day-to-day living, given interminable life on social media. Increasing distrust of governmental leadership offering citizen protection—the dearth of necessary laws, programs, preparedness, attitudes—has exacerbated rather than calmed these fears, strengthening the “perfect storm” that can best be described as societal burnout.
You may know that my 5-year study of the potentially life-threatening impact of personal and professional burnout led to an article published in The New Social Worker, “What I Wish I Had Known: Burnout and Self-Care in Our Social Work Profession,” which grew into the 2015 NASW Press book, Burnout and Self-Care in Social Work. Professional burnout motivated my initial research. Trusted social work colleagues and mentors working with extremely vulnerable children and families were leaving their jobs in droves, explaining that the lack of vital training and lack of services were “burning them the hell out.”
This initial focus revealed the necessity of studying the roots of personal burnout—“unfinished emotional business” (a phrase coined by Maggie Scarf in her 1995 book, Unfinished Business). When we do not assert ourselves protectively and creatively, have realistic expectations of others, or gravitate to and remain in relationship bringing pain and betrayal, we are strong candidates for personal burnout.
In recent years, however, growing numbers of clients in excellent physical health with rewarding personal and professional lives have shown documented signs of burnout that is societally-induced: difficulty breathing, persistent headaches, inability to fall or stay asleep, overwhelming anxieties. Other symptoms include feelings of hopelessness, lack of self-esteem, critical evaluation of accomplishments, quickness to anger, and detachment. Clients told me that they “felt like the floor beneath them was crumbling,” that they found no joy at work, and they could not control anger at home. As one explained, “I am constantly about to cry. When I’m alone and will not scare my kids, I don’t just cry. I sob.”
At the same time, a significant number of social workers, myself included, experienced parallel symptoms not originating in our personal and professional lives, yet impairing energy and focus in these areas. Clearly, we were experiencing the same problematic drains and reactions as our clients, for the same reasons.
Although the factors leading to societal burnout differ from those that lead to personal and professional burnout, they frequently exist together in an interactive loop for social workers. With frequency, we see societal burnout on top of professional burnout on top of personal burnout.
Unlike persistent, overwhelming depression, burnout as a syndrome can be alleviated and prevented through self-care strategies. The three underlying syndromes found in personal and professional burnout are also found in societal burnout. Without self-care incorporated into our day-to-day lives, we are susceptible to pervasive distress related to the suffering we see—suffering that should be urgently addressed, yet is not (compassion fatigue); pain, loss, and violence that surround and impair our clients, which no one is safe from (vicarious trauma and secondary traumatic stress); and the difficult, impossible people who have an impact on our lives, the lives of our clients, and the well-being of our country and our world (countertransference).
The self-care strategies that alleviate and prevent personal and professional burnout are well documented. They are similarly effective in facing societal burnout. Ones I know to be effective follow. Please consider offering others, sharing your experiences and ideas with colleagues.
- Understand the complex forces around you that lead to societal burnout. Are they also interacting with personal or professional burnout, or their combination? Understanding alleviates anxiety and restores energy.
- Remember that our bodies are our readout, reminding us of overload through symptoms. Our bodies also remember, and signal us, when clients speak of ordeals and traumas we or loved ones have also endured, or societal stress places us on overload.
- As soon as you are able, take leadership roles to address issues you are passionate about on local, state, and national levels. As an example, colleagues recently prepared slides documenting how future generations will be forced to live if environment hazards are ignored. They are presently being invited to discussion and book groups to present their findings online. Before the pandemic hit, friends and colleagues attended citizen swearing-in ceremonies, where as follow up they registered new citizens to vote. They will resume this as soon as possible.
- Get involved in the campaigns of the candidate(s) you believe in. Support those working on issues important to you through financial support, hosting meetings, and making suggestions.
- Run for political office. Do not be shy: social workers have so much to offer! Local boards and committees hold power and benefit enormously from social work representation, as do higher offices.
- Initiate discussion groups on societal, personal, and professional burnout at graduate schools, professional settings, and organizations. You will become invigorated through connection and discover new avenues of expression. I am finding it rewarding and uplifting to address this topic with students entering our proud, historic profession.
- Plan for outlets for social work knowledge through “out of box directions,” such as consulting about cases at local agencies, or advising local theater groups in understanding the characters in the plays they select.
- Remember that diversity of activities alleviates burnout.
- Despite this traumatic time, take a break, relax, and do all possible to have fun. We cannot work 24/7: to do so is exhausting, making all life challenges feel insurmountable.
- Follow the lead of health care professionals, and protect yourself and your loved ones in this period of enormous health concern. Remember that physical distancing does not mean social isolation. Share with others. Technology is a gift that makes this possible.
A personal conclusion at this grave and ominous time: When my mother was near the end of her life, her final cogent words to me were “to be continued.” I believe her meaning was three-fold, and very much the message of a “natural social worker”— in good times and bad, her love was a constant; facing harsh difficulties is always a process; we must never give up. Her words reminded me of the biblical message: life involves both feast and famine. A time of grave societal overload (famine) is now upon us. Yet, all we are going through shows how precious each life is, as well as how fragile. This awareness can propel a nation to finally realize how interconnected we are, and how urgent it is to address the long simmering societal problems that threaten each and every one of us.
SaraKay Smullens, MSW, LCSW, DCSW, CGP, CFLE, BCD, whose private and pro bono clinical social work practice is in Philadelphia, is a certified group psychotherapist and family life educator. She is a recipient of the Lifetime Achievement Award (2004) and the Social Worker of the Year (2018) from the Pennsylvania chapter of NASW, and the 2013 NASW Media Award for Best Article. In 2018, she was one of five graduates of the University of Pennsylvania School of Social Policy and Practice selected for the school’s inaugural Hall of Fame. SaraKay is the author of Burnout and Self-Care in Social Work.