Dr. Geri Puleo: Burnout and Post-Traumatic Stress Disorder at TEDxSetonHillUniversity (Transcript)

It doesn’t make sense, because all of you who’ve burned out, did you like that feeling? Yeah, you’re looking at me like, “She’s really nuts now,” right? But you didn’t like the feeling but why did you continue to be burned out? What was going on?

So then I started asking: well, how can we avoid burnout or if you’re already burned out, how do you overcome it and come out on the other side? Well, what that led up to is something that I call “B-DOC.” B-DOC is a Burnout During Organizational Change Model, and B-DOC is just a lot faster to say than Burnout During Organizational Change Model. This model was developed when I was doing my dissertation for my PhD, and I interviewed, very sensibly, people who had burned out to find out what was really going on. How did they burn out? Why did they burn out? How did they come out from it? What was going on?

And if you look at this, what I noticed – and I was focusing during organizational change – is all the people who burned out were the star employees. They were the ones that give me 110%. These were the ones who said, “I can do it. Give me more! Give me more!” But the problem is things happen, and they started getting frustrated. Maybe they didn’t have the resources. Maybe they had a boss who took credit for all of their hard work. What do you think happened after they got frustrated? They got angry.

I had one participant, a very intelligent man who said, “Well, I was a sales manager, and my best sales rep and I got into it. When we came back out in the bull pen, everybody was gone, and the pictures were skewed on all the walls.” He left the industry totally because the anger he could no longer control. After the anger, there’s some self-preservation that starts coming in. And these employees started becoming apathetic.

This is when the boss says to you, “Hey, we need you to do another project.” And they go, “Eh, huh Sure.” They don’t care anymore. After the apathy, then they went into full-blown burnout.

Now, I will tell you, burnout, if you can sleep it off in one weekend, you ain’t burned out. Because burnout just keeps on going and going and going. There’s physical problems with burnout. There’s emotional problems. Have you ever been in a relationship with someone who’s been burned out? They’re nasty! Very nasty. And in that burnout, it’s literally, it’s like the vacant shell of a burned out building. How many of you remember 9-11? How many of you remember that image of the World Trade Center where there is just one wall up and everything else was dead around? That’s what burnout is. These people feel like life is over.

It’s a bad situation to be in. And usually, when you hit it all the way down there in the burnout, then something comes up and you say, “I gotta get out.”

So what do you do? First off – withdrawal, removal, either physically or psychologically, the presenteeism in the workplace. They’re there, but they’re not really there. Or almost every one of my participants, left not only the employer, they left the whole industry. They couldn’t take it anymore; they wanted out. But that’s not the recovery. They then had to have self knowledge and acceptance. They had to understand what was going on. They had to accept it.

And then, finally, there’s a revised psychological contract with the employee. Now, some of you, when you looked at this chart said, “Boy, that is one of the worst inverted bell curves I’ve ever seen in my entire life,” because it’s not even. But it’s that way for a reason. The descent into burnout is really fast, but the recovery is very slow. So when you look at this, into this descent, the hope leads to frustration, leads to anger, leads to apathy, then finally, you’re in burnout.

For my change targets, for all of those people who where change was being done to them. It doesn’t matter what your title was, but if you were told to do something you had no control in it? Six months! Six months you were fried. For the change leaders, about one to two years. And I think the reason for that is because as a change leader, you have a little more control over it. But think about it, if all your subordinates you are trying to change are burned out, what does that do to your workload? Makes it even worse, right? And so it takes a little bit longer.

Now what causes that descent? Well, I found 10 organizational factors. One of the biggest problems with burnout and the thing that gets me really ticked off is most people say, “It’s your fault. You just have a maladaptive response to stress.” Well, you’re not. Some of the literature was saying that there can be organizations that are toxic. And this order was based on the frequency with which my participants identified it. Work overload is number 7. Most people think it’s a lot of work. That’s what makes you burned out. It isn’t.

Because you all know, if you’re doing something that you love, like some of the other speakers said, you can put a lot of time into that. You don’t care. Even Abraham Maslow found that in his hierarchy of needs. First thing was poor leadership. And then a lack of organizational caring. Burned out workers feel like cogs in a wheel. You’re not human anymore. You’re a robot, and nobody cares.

But as I said, while the demise into burnout can be quick, the recovery is painfully slow. And as I mentioned, the recovery takes about two years. Two years to get out of this – until you feel whole once again.

Now, here’s an issue: I wanted to know why it was so difficult to recover from burnout. You feel lousy. You’re not happy with your performance. Nobody around you likes you anymore. Why can’t you just get out of it? Well, it’s three things. It’s what I call The Burnout Triumvirate.

First off, there are certain personality types that are more prone to burnout. How many of you are over-achievers? I like the hands going, “I don’t want anybody to see it, but I really am.” Or any Type A personalities in here? One hand went, “Yeah, I’m going to admit it.”

Personality – those star employees are the ones that tend to burn out the fastest. But then, you also have physical symptoms. Now, this is what I found very upsetting about burnout. It’s not just fatigue, it’s a sheer exhaustion. There’s irritability. There’s an inability to concentrate. When you’re burned out, it takes you longer to get things done. Things that you could get done, you know when you’re cramming for exams, if you can cram it in one day? Yeah, when you’re burned out, you can do the same cramming, and you’re not going to get the material done.

The other problem is the disease. There’s been a lot of research done in terms of the effect of stress on the body. And the problem with burnout is that the diseases become chronic, ongoing, have you ever had that cold that you could never get rid of? Or there could be chronic sleep disturbances – waking up every two hours; difficulty falling asleep or just falling asleep at a meeting.

The other problem is it can be an acute disease. What I found really disturbing in my participants, is over 10% of them, once they left the organization to try to do away with the burnout, 10% of them developed cancer. This is serious. Burnout is a lot more than just “I’m tired,” or “I can’t concentrate.” It really affects you physically.

And then you’ve got the organizational factors. Most organizations say, “We expect you – ” Don’t you love the mandatory overtime, if you’re hourly? Mandatory overtime. How many of you are salaried employees and work just 40 hours a week? Yeah, it’s amazing, not one hand went up for that. Most people are working 60, 70 hours a week. And even when you’re on vacation, you’re still thinking about work. I had a friend of mine who went on an African safari. Now, how much farther away can you get, right? And he was chasing this one leopard. Yes, he got the leopard. It was really disgusting.

It was up on the mantle and all that kind of stuff. But he got the leopard. It took him two and a half weeks of being on safari before he realized, “Oh, I’m on safari and trying to get a leopard.” He was that fried with it. So when you look at the problem with the organization they create these situations that create toxic environments.

Now, the other thing you have to remember is something that I have here called “residual burnout.” Residual burnout is something new. And what it says is you decide to leave the job. You’re starting to have a better understanding of what’s been going on. And then something happens and bam! you go right back into frustration, anger, apathy, or full-blown burnout.

I think this is one of the reasons why so many employees are no longer engaged or committed, because they’ve been burned out so many times, and if you look at the B-DOC Model that revised psychological contract is not at the same level of hope and enthusiasm it was prior to the burnout.

So if you look at employees who have burned out, it is a long term effect. So, as I said, recovery takes two years, and that’s conservative. One of the people that I interviewed was executive director of a non-profit. Had to stop in the middle of the interview, went to the restroom, came out, and shaking uncontrollably with tears. She said, “Oh my god, oh my god I’m shaking. It still hits me like this.” Her burnout was 20 months before. And I started looking at this, and I thought, this is like Post Traumatic Stress Disorder.

Now, you’ve got to realize, when I was doing this research, people looked at me like, “Oh yeah, burnout’s like Post Traumatic Stress Disorder, yeah, Geri, right.” So I started doing some research. And the similarities between burnout and Post Traumatic Stress, PTSD, are shocking. In fact, I’m a firm believer that burnout is a form of PTSD. In the last column is all characteristics of Post Traumatic Stress: exposure to a traumatic event or an extreme stressor.

People who get burned out normally get burned out because they keep on going and going and going, and there’s no reprieve. Their health starts going bad, their personal relationships start going bad, their boss doesn’t like them, they were overlooked for a promotion, it just keeps building and building and building burnout – check. Responding with fear, hopelessness, or horror. When people are in the throes of burnout, they have no feelings any more. They’re like robots. They’re afraid to feel. They feel absolutely hopeless. The hope is diminished. Like burnout – check.

Sleep disturbances and nightmares. As I said, with burnout, that’s one of the big issues, they’re constantly waking up, they can’t go through a full night’s sleep – check.

Another PTSD: depression and withdrawal. Depression, according to Freudenberger who looked at burnout in terms of a sequence of 12 to 13 steps, depression is the immediate precursor to a full-blown burnout. So is the depression and withdrawal of PTSD the same thing as burnout? Check. Frequent mood changes. Generalized irritability. Typical of burnout? Check. And avoid activities that promote recall of the traumatic event.

One of the things that I found with my participants is they all said, “I gotta get out of the industry.” “I have to leave this employer.” “I can’t stay here.” “I can’t survive.” And then when they get into a new work environment, what happens? Anything that happens that’s similar to what they went through before, bam! Residual burnout, they re-live the experience all over. So the similarity between burnout and PTSD are eerily similar.

So, here’s my question: what if burnout is a form of PTSD? What if it is? How many of you have heard of the Americans with Disabilities Act? Are you aware of the amendments to the Americans with Disabilities Act? Let me tell you a little bit about ADA and ADAAA.

Under the ADA, employees who experienced Post Traumatic Stress Disorder had a very difficult time in court because what was happening is they were getting disciplined for the outbursts that they would have. They would have a flashback in the workplace. They would act out. That didn’t abide with the employee’s way of doing things, and they were disciplined.

The problem under ADA is that that employee could not prove that PTSD was a disability. And, they were not separating the disability from the symptoms. I mean if you have PTSD, there are going to be certain behavioral symptoms, right? And they were trying to separate them. Any mitigating factors, for example, if you were seeking therapy, you were talking to a psychologist, guess what? You don’t have an ADA claim.

Well then the ADAAA came out. And they stated that PTSD is de facto a physical, not a psychological, physical disability. And what does that mean? Something called “reasonable accommodations.” Now with a reasonable accommodation for someone who has PTSD, there are no mitigating factors so it no longer matters under ADAAA. If you are taking treatment, if you are dealing with a therapist, or even if you’re not displaying the symptoms of it, you still have to have a reasonable accommodation.

And here’s a couple: additional time to get something done; understanding if you’re late for work because you didn’t sleep the night before; trying to make sure that the employee is not exposed to situations that’ll trigger those flashbacks. These are all reasonable accommodations.

So again, I ask, what if burnout is a form of PTSD? In other words, how would the workplace change if burned out workers had to be reasonably accommodated under ADAAA? What would happen? Well, several things. There’d be a fundamental shift in company policies and practices. In other words, how many of you have actually taken your vacation? Oh, I love the looks on your faces, “No, not really.” Or did you take a vacation and you kept calling in? Here’s the thing: if these reasonable accommodations for burned out employees had to be put into the workplace, vacation, downtime, paid time off or even unpaid time off would have to be admitted. You’d have to do it.

Also, there’d be a shift because there’d be recognition and appreciation of your efforts. How many of you wish you had that? And then finally, what does that lead to? Creativity, innovation, and better ideas and products for the organization. So what all this triggers down to is if employees have to do reasonable accommodation, then their performance, the productivity, and the satisfaction of the workforce as a whole is going to shift. It’s going to get better.

So, here’s some of my final thoughts. I think burnout is the canary in the coal mine. And what does that mean? Canary birds were taken into the early mines in cages in order to detect the presence of the odorless and lethal gas, carbon monoxide. So if you have employees who are burned out, and that’s the majority of your workforce, think of them as the canaries. They’re succumbing before the company does, because they’re going to miss deadlines; they’re going to miss opportunities and threats to your company; the employees won’t have any new ideas and no new products; there’s going to be poor customer service; there’s going to be bad decisions made; and finally, your company is going to be subjected to lawsuits and litigation.

So in closing, the Americans with Disabilities Act Amendment have changed everything. Burnout and PTSD are frighteningly similar. And if burnout can be defined as a form of PTSD, then companies are going to have to reasonably accommodate. So my question for all of you as current employer or future employers: are you going to be proactive by putting more humanity back in the workplace and reasonably accommodating your employees so they don’t burn out?

Or are you going to sit around and be reactive and wait for an ADAAA lawsuit? All I ask for all of you, including new graduates, when you get into the workplace and you get into those leadership and management positions, remember the humanity of your workforce. So I want you to keep the human in human resources. What is yours? And if you’re wondering how I avoid burnout, I got a dog. That’s my Duke. And, that’s it. Thank you.

Related Posts

• Transcript of An Ethicist’s Guide to Living a Good Life – Ira Bedzow
• Transcript of Resilience: How to Emerge From Your Tragedies Stronger – Sydney Cummings
• Transcript of Confessions of An Accidental Killer: Gregg Ward
• Transcript of How to Spot Liars at Work and How to Deal with Them: Carol Kinsey Goman
• Transcript of The Secret To Conflict Resolution: Shannon Pearson