In my daily contact with people involved in aid, development and humanitarian work, I repeatedly come across signs of physical, mental, spiritual and emotional exhaustion, including my own. I find there is often shame around it, maybe sprinkled with “self-cynicism“. Many burnout without knowing it, there’s an urge to keep going, and a sense that our personal well-being and good mental health are not worth looking after. Indulgence is the word for it. In the book Mindfulness. Finding Peace in a Frantic World, Prof. Mark Williams and Denny Penman discuss the idea of the ‘exhaustion funnel’ (see image below) to describe how we are pulled into the dark pit of burnout when we fail to care for our own psychological/emotional needs. The concept was developed by Prof. Marie Åsberg, expert on burnout, at the Karolinska Institute in Stockholm.

The top circle represents how we are when we lead a balanced and healthy life. ‘As things get busier’ Williams and Penman notice, ‘many of us tend to give things up to focus on what seems “important”. The circle narrows, illustrating the narrowing of our lives. But if the stress is still there, we give up more – and more. The circles narrow further. Notice that very often, the very first things we give up are those that nourish us the most but seem “optional”. The result is that we are increasingly left with only work or other stressors that often deplete our resources, and nothing to replenish or nourish us’ (Williams and Penman, 2011: p. 212). Burnout is then the result. The authors highlight how it is often committed and conscientious people, and ‘those whose level of self-confidence is closely dependent on their work-performance’ who are likely to burnout. In aid work many are highly committed and may feel there is no room to nourish themselves amidst conflict, poverty, or natural disasters. The reality is that we all need a respite to nourish and refuel.

If burnout is now beginning to be accepted  and talked about as a reality among aid workers, health professionals have been aware for sometime of how healing oneself, is a prerequisite for healing others. I have been reading Kitchen Table Wisdom and was inspired by the words of Rachel Naomi Remen, a medical doctor who tells stories that resonate very much with my experience of aid work, and possibly with that of many professionals and volunteers on the frontline who witness other people’s suffering day in and day out. Remen describes how ‘professionals don’t cry’. In aid work, as in the medical profession, this often means neglecting our own disappointments, losses, and grief, and get onto the next humanitarian tragedy. Burnout – often a consequence of stress and fatigue accumulated over time without noticing the messages that our body was sending us – can be an intense lesson in caring for oneself as a means to serve others. Remen’s words shed light on the importance to look after oneself, to heal within, in order to be able to reach out:

“The expectation that we can be immersed in suffering and loss daily and not be touched by it is as unrealistic as expecting to be able to walk through water without getting wet.

This sort of denial is no small matter. 
The way we deal with loss shapes our capacity to be present to life more than anything else. The way we protect ourselves from loss may be the way in which we distance ourselves from life.

Protecting ourselves from loss rather than grieving and healing our losses is one of the major causes of burnout. Very few of the professionals I have treated for burnout actually came in saying that they were burned out. I don’t think most of them knew.

The most common thing I’ve been told is, “There’s something wrong with me. I don’t care anymore. Terrible things happen in front of me and I feel nothing.”

Yet people who really don’t care are rarely vulnerable to burnout. 
Psychopaths don’t burn out. There are no burned out tyrants or dictators. Only people who do care can get to this place of numbness. We burn out not because we don’t care but because we don’t grieve. We burn out because we have allowed our hearts to become so filled with loss that we have no room left to care.

The burnout literature talks about the factors which heal burnout: rest, exercise, play, the releasing of unrealistic expectations. In my experience burnout only really begins to heal when people learn how to grieve. Grieving is a way of self-care, the antidote to professionalism. Health professionals don’t cry. Unfortunately” (extract from Kitchen Table Wisdom).

If we were to substitute the words health professionals with aid workers, we could sense why in the aid/development/humanitarian community (I am tempted to say in non-profit community as a whole), many people who truly care reach the black pit of the exhaustion funnel and burnout. It may be useful to remind ourselves that self-care is not a selfish, indulging act. Every day we have the option to relate differently to stress, take a breathing space, go for a walk, altering the balance between nourishing and depleting activities. Small self-care actions, such as doing something pleasurable every day, can enhance our sense of mastery over our life, gradually enhancing our sense of well-being, and our effectiveness and ability to care as “do-gooders”.

Sources: 

Mark Williams and Denny Penman, Mindfulness. A Practical Guide to Finding Peace in a Frantic World (Piaktus, 2011). The Exhaustion Funnel, from William and Penman (2011)

Rachel Naomi Remen, Kitchen Table Wisdom (Riverhead Books, 1994)