Several years ago, because so many in my field were leaving work they trained for arduously and cared deeply about, I began six years of research into the reason that the majority gave for their decision -- burnout.
Burnout can be best described as a state of overload, understandable in our fast paced, 24/7, wired, demanding, ever changing society. It develops because so much is demanded of one so relentlessly that it feels utterly impossible to know how to begin to meet expectations. Signs of burnout are withdrawal; not caring for yourself; loss of a sense of personal accomplishment; feelings many are against you; desire to self-medicate with drugs, alcohol, or a combination; and finally, complete depletion.
While burnout can be confused with depression, and both conditions reveal an overriding negativity -- as if of a black cloud permeates all -- depression usually results from a traumatic loss (such as death, divorce, unwanted professional change), as well as betrayal, connivance, and persistent relationship conflicts -- or it appears for reasons that are unclear. With burnout the culprit is always overload, and my research showed that carefully selected, evidence based self-care strategies in one's physical, personal, social, and professional lives (where burnout occurs and interacts) will alleviate and prevent it.
Interestingly, after my research was completed and shared in a published book, Burnout and Self-Care in Social Work: A Guidebook for Students and Those in Mental Health and Related Professions (NASW Press, 2015), I began to see clearly that my work on burnout among mental health professionals also applied to pain and depletion in the lives of married couples. Reasons causing it were comparable, and carefully chosen self-care strategies woven into day-to-day life also alleviated and prevented it.
It is important to note, however, that while marital problems often lead to depression, burnout occurs, not from marital problems, but from overload. (The primary exception to this is when one takes on far too many activities and responsibilities to avoid facing marital problems.) Burnout, however, can and does cause marital difficulties. The following examples describe understandable reasons for marital burnout and ways to set yourself free.
Sylvan and Marian: Wired 24/7 to a demanding and selfish boss
Sylvan and Marian were each in their late thirties. Married for twelve years, they had two children, ages 10 and 8. Each also worked outside of the home. Sylvan managed a trucking company; his employer demanded constant availability and relentless work. Marian taught fourth grade. "Each of us has so many responsibilities, no time to rest, and no quality time together," Marian told me during our first appointment. Her husband's words were also telling, as well as predictable: "We are constantly exhausted and then, when we have a little time together, we pick on each other, as never before. It seems we are no longer friends on the same team." "Then there's this third active participant in our marriage," said Marian, holding up her I-Phone. "It is always there, and Sylvan is afraid not to respond to his boss's constant intrusions in our family life and time." Sylvan nodded to this truth, explaining, "I can't afford to be fired."
Here's how burnout in the lives of this couple ended: Sylvan was an excellent employee, severely underpaid and taken advantage of. He would not easily be replaced, and even in a tough job market, his skills and work ethic made him highly employable. He built the confidence to tell his boss that due to his many responsibilities, an assistant to him must be hired, and that unless calls in the evenings and weekends were of an emergency nature, they would have to wait until the next day or the end of the weekend. Further, he said a raise was essential. The strategy worked because of Sylvan's newfound confidence and his employer's realization that Sylvan would no longer be taken advantage of and was not easily replicable. In addition, the couple promised themselves and each other an important and intimate addition to their life together -- regular "date nights."
Stacey and Dave: The Toll of Compassion Fatigue
Stacey was a doctor who worked in a cancer center for children, and Dave was an accountant. They were in their mid twenties, newly married, and hoped to begin a family within the next few years. Stacey would return home during her workweek and withdraw from her husband, turning to several glasses of wine until sleep came.
Our work together concentrated on Stacey's over identification with the families she met, the children she treated, and their hardships. In order to find balance in her life as a professional and with Dave, Stacey had to learn to achieve mature perspectives and boundaries. It was necessary for her to see that although she cared deeply for her patients and their families, she and those she worked with were not attached. They were separate people, whose challenges had to be left at the hospital when she was not on call.
It was also necessary for Stacey to look at her chosen work in a new, positive way: Although she had chosen a profession where she saw constant suffering, it was also one that offered enormous hope.
Through these self-care perspectives, Stacey alleviated the dangers of burnout and its toll on her as a doctor, wife, and future mom.
Dolly and Steve: The Impact of Trauma
Dolly was a stay at home wife with twins, a boy and girl, age 8. Steve, a pharmacist, tried all he could to help his wife deal with her overwhelming fears, but all of his efforts failed. Married at 20, the constant realities of deaths due to violence that is permeating our society left Dolly with ongoing feelings of helplessness and terror. "I feel that this violence is actually happening to me, my husband, our children," she told me crying and shaking during our first meeting. "Even though I know in my head, it is not, I feel in my heart that it is."
Further understanding about Dolly and Steve's lives showed that saving for the future meant that this couple (and later family) had never taken a vacation. There was never a break, a relief from their responsibilities and stress.
Now, each summer the family enjoys a week holiday at a reasonably priced beach resort. In addition, each winter Dolly and Steve find time for their own private get-away. And yes, "date-night" is also regularly woven into their lives. This quality self-care approach has alleviated Dolly's exhaustion and given her rational perspective and coping skills.
Cynthie and Scott: Piling on Responsibilities and Activities to Avoid Facing Marital Truths
When Cynthie was a graduate student at a prestigious university in England, she met Scott, who was handsome, charming, and on the verge of flunking out, which he subsequently did. Never confident in her femininity, Cynthie was overjoyed that such a handsome man desired her. When Scott proposed Cynthie accepted, despite misgivings about the kind of husband and father Scott would be.
Knowing that her parents would not approve of this marriage, Cynthie and Scott eloped, and after the couple came to America to begin their married life, Cynthie soon found out that her misgivings should have been given far more weight. While she worked hard to develop her marketing career, Scott was happy to remain jobless as well as open to other sexual relationships.
Cynthie's overriding fear was that leaving Scott would doom her to a lonely, isolated life. To escape these fears and the growing tensions and insults in her relationship with her husband, Cynthie took on increasing professional responsibilities. She even began a second master's degree program in economics. Within months of this decision burnout set in, and Cynthie was referred for therapy.
After hard work to understand and address her lack of self-esteem and confidence, Cynthie asked Scott to join her in therapy. He refused, demeaning her attempts to address their glaring problems. Cynthie clearly realized after 6 months of therapy that she had been hiding from truths about how she had been living. She knew that the best self-care she could give herself was divorce, and she followed through with this necessity.
Author's Note: A version of the above article appeared on the website Marriage.com on September 8, 2016