Understanding Job Burnout (London 2019)

Burnout is a hot topic in today's workplace, given its high costs for both employees and organizations. What causes this problem? And what can be done about it? Empirical findings show that burnout is largely a function of the social environment in which people work. The key sources lie in 6 critical areas of mismatch between the person and the job. This talk will review major new insights into the causes and effects of this problem, and will discuss the most promising strategies for dealing effectively with it. Christina Maslach is a Professor of Psychology (Emerita) and a researcher at the Healthy Workplaces Center at the University of California, Berkeley. She received her A.B. from Harvard, and her Ph.D. from Stanford. She is widely recognized as one of the pioneering researchers on job burnout, who has written numerous articles and books, including The Truth About Burnout, and has developed the leading research measure (the Maslach Burnout Inventory). Several of her articles have received awards for their significance and high impact, including her longitudinal research on early burnout predictors, which was honored in 2012 as one of the 50 most outstanding articles published by the top 300 management journals in the world. Recently, she received the 2017 Application of Personality and Social Psychology Award, as well as a lifetime career achievement award for her work on burnout. Christina received national recognition as Professor of the Year by the Carnegie Foundation and The Council for the Advancement and Support of Education. She has been president of the Western Psychological Association, is a fellow of the American Association for the Advancement of Science and of the European Academy of Occupational Health Psychology, and has received the Berkeley Citation and the Distinguished Teaching Award from U.C. Berkeley.

plenarylondon2019
DC

Dr. Christina Maslach

Professor of Psychology, Emerita, University of California, Berkeley

TRANSCRIPT

00:00:01

Our next speaker is Dr. Christina . She is professor emeritus of psychology, and the healthy workplace is center at the university of California. Berkeley. Her research focuses on burnout and job stress, as well as the positive antithesis of burnout, which has workplace engagement as a better framework for developing interventions. Uh, some of you may have seen the incredible press that this topic has had recently, uh, because the world health organization has recently declared burnout as an officially a workplace condition. This is based on the lifetime of research of Dr. Masse Lac and has raised the visibility of this topic to the highest levels of the organization and even corporate boards, especially in the fields like healthcare, as indicated in this New York times article here. Uh, I want to thank Dr. Masek for a lifetime of amazing work. Uh, and I want to thank John Willis on our program committee for introducing her work to me. Uh, we're living in an age where workplace engagement, as you heard earlier from, uh, Joe ahow CFO of Compuware about how important engagement is for the success of any organization. It is a board level topic, and here's a way for us to attach our goals and aspirations to those directives. Uh, we know this is a better way, so I'm so excited that Dr. will be presenting her work, uh, for you today. Coming out document is last

00:01:31

Okay now for something entirely different, no code, but we're going to talk about climate and we're going to talk about colleagues and what it is that leads all of this to burnout. And I want to share with you what we understand about burnout up to this point, and then hope that be helpful as you move through and do other kinds of things. So I've been working on burnout and many colleagues of mine have also been doing this for several decades now. And we started with healthcare and human services, and healthcare continues to be a place where we see a lot of issues around burnout, but human services of all kinds, including ministry, including all sorts of ways in which people try and help cure teach, you know, assist other people in some ways. Social activism also is another area where we've seen a lot of it.

00:02:30

Uh, more recently though, we're seeing some changes, uh, caring a lot more from tech industries, hearing a lot more from customer service industries than we did before. And what we're seeing is a similar kind of pattern, obviously some unique differences, but in important patterns. So what are some of the things that we've learned about what is happening with burnout today? One is that the workplace, and it is a workplace phenomenon. Uh, it has changed. It's not what you know, people used to be doing. The workplace was a very different kind of environment, 40, 50, 60, more years ago. And here are some of the things that are actually changing that environment and making things like stress and burnout, a little bit more of a risk. So we see fewer full-time careers. I'm a full-time career as a professor in a university, and I'm feeling like a dinosaur these days.

00:03:29

There's not many people, you start the job and then you end it and retire. Um, so multiple jobs leaving, going different places. Um, what I am seeing, and this is one of the themes that I'm going to emphasize is a lot of it has to do with people in their workplace environment. And what we're seeing is less concern and commitment for employees in terms of taking care of them, giving them appropriate benefits, making it a job that you can have and still have a life beyond, you know, beyond that, we're seeing a lot more destructive competition between coworkers. When I say destructive, it's the kind of throwing the other person under the bus. So they won't be a threat to you when you come to promotion time. Uh, and what this is creating is a climate of fear in a lot of workplaces where people are afraid to speak out.

00:04:21

They're afraid to confide in someone because they really don't know who's their friend who will, you know, treat this confidentially will help out as opposed to becoming their worst enemy. There's a lot more tactics being used that re you know, reward, quote unquote talent, uh, but not everyone. So there's, you know, again, this more sort of destructive competition, um, people talking about getting shut out of opportunities after not a long time. And it's kind of like at some point you're going to be Deadwood and this is it, and this is not going to change, and this is going to be your life, unless you can find something else. And also very concerning to me is a feeling that the common good that what we're trying to do, uh, whatever, you know, kind of industry or occupation we're in is to benefit the larger society, the larger world.

00:05:16

There's a common good that we practice that we're also all about as a core value. So it's more about me than it is about we, uh, and that changes again, the dynamics of how people are working together in the workplace. So the model that we're seeing more and more of army members seeing back in Silicon valley, just down the road from where I live, uh, back in the sixties, early seventies, and it's called the burnout shop. Um, this was not the first time that I heard about burnout, but, um, uh, it was used. And I think actually my dad was an engineer, uh, and working in a lot of stuff having to do with the space program. And I remember burnout as a word, probably came from engineering. In some ways we talked about he was doing work with NASA. So there was things about the rocket boosters, the burnout, you know, as you're carrying things into space, ball-bearings burn out and why, because they're in an abrasive environment and they don't have adequate resource in this case oil.

00:06:19

So there's a lot of things there that sort of suggest to me that this is maybe where the origin of the term came from, but we're not absolutely sure any rate, what is the burnout shop? It was at that time, a short term startup, and basically people were advertising. We're a burnout shop. We only want type a plus plus plus people. We are going to work you to death for a couple of years, 24 7, that's our motto. And when you burn out and you will and have nothing left to give and nothing more, you can do, you're going to leave and we'll get somebody else. Or maybe at that point, we'll have enough stock options. You'll be happy, we'll be happy. Um, it was a kind of a model which was for short term, it was in the self-sacrifice model. Uh, it was something that was only supposed to be for a short time, but what we're seeing more and more is that kind of model of self sacrifice that the rest of your life is becoming the model for the marathon, the long-term jobs, not the short-term lot of these places collect data, they collect big data and they say, we're looking at all kinds of things.

00:07:28

They tend not to collect big data on the human costs of this. And I've listed a few of them up there that researchers like me and other people do keep track of. Um, and there are human costs that come with this stress, health problems, physical exhaustion, sleep deprivation, a major thing, uh, disruptions of personal life. You're becoming this couch potato, and you really don't have great relationships and your family isn't working out and you really don't want to do things with people and all the rest of it, uh, a loss of your own sense of I'm doing something good and I'm feeling good about it, feeling good about the achievements burnout, but sometimes they can also go to much more serious mental health issues like depression, likings, anxiety, and we're also seeing it LinkedIn possibly, you know, to suicide. And certainly in tech we've been seeing and hearing about a lot more, particularly at younger ages on this.

00:08:34

Now it's interesting because when I used to talk to people who were running different kinds of organizations and sort of trying to say I'm, you know, been interviewing people and finding out more about burnout. And I remember once early on running into a CEO who said, oh, I think burnout is great. That's a really wonderful thing. And I was going, oh, okay. And why do you think that? And he said, well, if they burn out, it must mean they're not good enough, not strong enough. They can't take it. Right. So this is not a good person. That's somebody I want to hang on to, but if they burn out, they'll quit. I don't have to go through the process of firing them. So I think it's a good thing. This was a little interesting concept to me at that point. But any rate, this is, this is how they felt about it.

00:09:23

So we're talking about unhealthy jobs on the healthy workplaces, for people who are supposed to thrive and do their best and be innovative and break rules and all the rest of it. Okay. So the problem that we have a lot is a problem of unhealthy jobs, unhealthy workplace. And this is not news. This has been known for a very, very long time. And what have we known? Well, we know that there are certain kinds of job conditions that are highly stressful and toxic for human beings. And I'm just listing a few long working hours, high demands, insecurity, lack of control, low social support among the people you work with, work, family conflict, and there's more, but data has been collected on this for years, decades. This is not news. We know this, what else do we know? We know that these job conditions, these kinds of stressors pose a danger to people, to human beings.

00:10:33

It has negative effects can have negative effects on their overall wellbeing. So what are some of the metrics for that increase in annual unnecessary deaths in healthcare costs, lower worker, life expectancy, more working hours, loss, greater risk of burnout, depression, and more lot of data on that. And what also happens is that when people begin to have these kinds of problems, it shows up at work, they are absent. They're out on sick leave. They turn over more quickly. They quit, they make mistakes and errors. Sometimes very major ones. They are not doing high quality work, not checking and so forth. So there's a lot of evidence of all of that.

00:11:24

And it turns out there's actually a lot of evidence that these job conditions, no matter how much they are justified, we have to do it this way. There's not a lot of good evidence that they actually contribute. And in, you know, ensure productivity, all the errors, the problems, et cetera, or, you know, the bottom line economically, the estimates of how much stress and burnout is a stress phenomenon, how much this costs, the latest estimates are 200 to $300 billion, uh, in terms of productivity, losses, absenteeism, turnover, sick, leave, all of these kinds of things. So it's, it is a major problem. It's a major problem. It's not new, it's known. And if you really want to look at more of the data on all of this, I recommend a book that came out last year from the business school at Stanford called dying for a paycheck, how modern, modern management harms employee health and company performance.

00:12:29

So, you know, this is something that is well-known why are we still having these kinds of problems? The mantra that I'm hearing from a lot of people, when I go and meet them and interview them in different workplaces is what they're hearing, sorry, but we have to do more with less. And what I think we're seeing more and more is that that's the kind of mantra of the burnout shop. We expect more from you. You're going to have to work longer. You're going to have to work harder. You're gonna have to take on more responsibilities, but sorry, we can't hire more people. We can't pay you more. We can't bring in the resources that are needed. So this is really setting people up in a sense for more of the risk of burnout.

00:13:18

Okay. Now this slide, well, science is one. I hope you remember when you leave here because it quickly summarizes what a lot of the research has been telling us, which is that the job and the conditions, the climate, where people work and the people themselves, the extent to which there is a good fit, a good match, but balance between those in these six areas. And these are the six we've found so far, maybe there'll be more later, but these are the ones that will predict burnout down the road. Or if it's looking good is going to predict greater engagement in the future, down the road, they are not in order of importance. They're probably an order of how much people think about them and recognize them. So everyone thinks, first of all, of workload too much, not enough, you know, a lot of demands, not enough resources, all of that kind of thing.

00:14:25

And that does, you know, that is a factor. It leads to the exhaustion of stress and burnout, but sometimes it's not the most important one. These other five sometimes are more. So the second one has to do with control, how much autonomy, how much say how much choice, how much, you know, uh, wiggle room you have in terms of doing a good job coming up with new things or whatever, or are you boxed in, locked in and can't make those kinds of decisions. Third area has to do with reward. And it turns out from the data that it's not so much about tangible rewards like salary or bonuses or perks. It turns out what's even more important is that you're getting social rewards recognition that somebody's lot of people, one person, whatever notices what you're doing and lets you know, that they thought that was pretty cool or we should do more of it.

00:15:25

Or there was a great idea or thank you for being there and really saving us on this one. So that's social recognition is coming out very important. Community refers to the workplace community. These are the people that you come in contact with on a regular basis. So it's your colleagues, people, you supervise bosses, vendors, clients, you know, whatever those kind of people are in terms of the work you do. And what happens here is do you have an environment in which there is good support, ability to work together, figure out how to do things you can count on people they can count on you or do you have something that increasingly people described to me as socially toxic environment? I like what I have to do. I can't stand being with these people in my unit and team because they are, you know, and they'll go off on the, on the list.

00:16:26

Um, so when that community begins to go south, in terms of negative kinds of things, fear, um, really bullying, bad kinds of, you know, interchanges and so forth. It turns out to be really predictive of problems in the future. Uh, fairness, this one hasn't been looked at as much, but it turns out it's sometimes really, really important and that is whatever our policies are, whatever our procedures, whatever our practices are in, in our organization, in where we work, are they fairly administered? Are the people who doing certain things, the ones who get promoted or get the new opportunity or whatever it happens to be, or does it, you know, are there other things going on, depends who, you know, rather than what you do and finally values. And this is really what gives meaning to a lot of the work we do and feeling like this is worthwhile.

00:17:26

It's making a difference. I really believe in this. I have some passion for it kind of thing. That'll keep you going through all kinds of bad times, tough times and so forth. And so is that happening in the workplace or are there value conflicts and ethical issues? So these are the six areas where we find that again, if there's one or more of these areas that have problems in it in a negative way, we see the longitudinal research, Raider burnout risk down the road. And what does that look like in terms of mismatch? Well, here's one possibility you get a demand overload. The imbalance is that there's way too much to do, cannot be done because you have not the resources you don't have the time. You don't have the other people. You don't have the tools enough to be able to get it done and do it well.

00:18:22

There's a lack of control. You, you are tied in and boxed in tie down in terms of how you can go about and do the work, the best job you can insufficient reward. This is one that we see a lot, meaning basically that you do a good job. Nothing happens ever. I've asked a lot of people to describe a good day at work. And particularly in healthcare, for example, a good day is when nothing bad happens. There's no positive thing that occurs. It's the absence of bad stuff, no screamers, you know, know all kinds of other things going on and working in that kind of environment where you never, you know, the best you can hope for is that nobody will complain and there won't be a crisis or a problem is a difficult place to keep working in on the long term break down of community.

00:19:24

Oops went too fast. But the breakdown of community is really problems with the working relationships that you have with all these other people on the job. And when we've got that socially toxic environment, you can't trust people. You're always fighting. There's bullying going on. There's all kinds of difficult stuff, big predictor of burnout, absence of fairness. This can really cause a lot of problems when people feel this is where discrimination lives, where glass ceilings are, where you know, it's not being fairly done in terms of this. And this leads to a real erosion of values and commitment and so forth. And finally value conflicts. You're put in a position where you're doing something you think is wrong. It's unethical, you're practicing one thing, but it's being preached something else in you're really being caught in the middle of this. So when we see more of these mismatches, we see more burnout.

00:20:31

We don't know yet from the research that some of these are more important than others. There may be individual differences in some ways. So there's still a lot more to learn about this. Okay? So burnout as stress phenomenon, what is it? And as Jean said, we've, you know, this just a month ago, maybe a couple of weeks ago, the world health organization has recognized burnout as a legitimate occupational phenomenon and given it a code and everything, and the next ICD, which is the international classification of diseases, but it is not a disease. And the world health organization said that how many of you saw any articles coming out about burnout is now a disease and your doctor can diagnose you. Anybody saw that like in like the times and stuff like that, you know, NPR or whatever, they got it wrong. They didn't read what, who said world health organization.

00:21:39

It said, it's not a disease. It's something that can lead to other kinds of health issues and can lead people to go to health institutions for help. So this is the, you know, it's talking about stress and they defined it exactly. As I've been defining it right here, they defined it as a response and occupational phenomenon or a response to chronic stressors in the workplace. Okay. Which they said have not been managed successfully. And then they say, and it's characterized by three dimensions. And here are the three, the exhaustion, this is the classic physical stress response, but it's not exhaustion alone. There has this negative take this job and shove it, attitude, the cynicism, the socially toxic workplace, you know, can't really, you know, don't really like what I'm doing. Like what I, the kind of work I can do, but it's not great here.

00:22:47

And the third one is a negative response, not test to the job at, to oneself. And so the professional in efficacy feeling like people often, it's interesting how often it comes up in interviews that people talk about the erosion of my soul, that I don't have a future. Maybe I'm not good at this. Maybe I've made a huge mistake going into the kind of work that I'm, that I'm doing. So we see all three of those together intertwined as the burnout phenomenon. It is not a disease. Although some people have said that it'll be news to doctors who are often talking about burnout themselves, that they are the ones going to diagnose this. But no, this is not what who said. It said, it's not a medical condition, but it is this kind of a stress phenomenon in the workplace.

00:23:38

So it's been interesting yesterday. A number of you were coming up to me, if you recognize me at all or saw my name tag or something and said, I've taken your measure on burnout. And you know, my response is okay, what did you learn? I mean, you know, what, what happened as a result of that? So the MBI them as lack burnout inventory is the measure. It's a research measure, which I developed years ago, um, to do the work on burnout, it assesses the three dimensions of exhaustion, cynicism, and efficacy. It doesn't ask if you agree, it asks, how often do you feel this way? And there's several different points that we ask. And each of those scores are looked at separately because if you add them, you can get the same total with different combinations. But the point is looking at those, you can get different patterns, different profiles. And we've been looking at what is predictive of those profiles? What are the outcomes? What might make a difference? A lot of people wish it wasn't so complicated and want it to be one thing like only exhaustion and have one score and not three. Um, but sorry, folks. This is what a lot of the evidence suggests we need to do it. So I have to say I'm really pleased that the world health organization agreed with all that evidence. And that's what we've got now.

00:25:05

Okay. So what are those profiles? What do we find when we look at the scores on the MBI and other things? Well, we basically find at least five different patterns. One is the burnout score and you've got three high negative scores, high on exhaustion, high on cynicism, high on the, in efficacy. Okay. But there's also disengaged. And this is where people only have one high negative score. The others are moderate or low, something like that. And they're just high on cynicism. That's the one that's coming out. We call them disengaged. We then have people who are showing only one high negative score on exhaustion alone. And that we call overextended.

00:26:04

We then get people who have one high negative score. It's only on in efficacy. And these are people who, you know, they're, they're okay with the exhaustion. They're okay with us. You know, they're not showing that, but they are showing negative self-evaluation. And then finally, we get a pattern where all three are not negative, they're positive and recall that engagement. So these are the five profiles that come out. And what we're finding is that they show different patterns in terms of how they deal with work, how they respond to changes and so forth. So here's some recent data.

00:26:49

This is all physicians in this case. And we're showing the five profiles we're showing the six areas of work-life that I talked to you about. Plus one more because they insisted that we ask them some questions about administration and how they felt about it. And that's the little green one. But as you look at the profiles, you can see that on the far left, this is the engaged group. They are looking way better than most doctors. That's a baseline for physicians. So they're looking better than average. And you're seeing burnout on the right side. And they are looking very bad, you know, on everything, those six areas, but look at the three in the middle. Cause we don't talk about those as much or people haven't paid attention as much, but the one that's right in the middle overextended is the high exhaustion group. That's all that's, they have high exhaustion, they have one big issue.

00:27:54

And it's workload that big blue line, big imbalance between demands and resources on that. But for people who think burnout is only exhaustion and there are some who do it, doesn't look like the burnout profile, it looks different. And what you would do for people who are showing that kind of profile would be different than if you were trying to, you know, make a more positive difference with people in a full burnout mode, um, disengaged. This is the high cynicism group, and they're beginning to show a similar pattern to burn out, which sort of suggests and there's other data to support it. That when it's that negative, hostile, cynical, you know, kind of response that may be maybe a more important marker than the exhaustion. Um, and one of the reasons I think that is because, um, when people really begin to develop that kind of cynicism, they change the way they're doing their work. So instead of trying to do their very best, they're trying to do the bare minimum. What is the least I can do get out of here, still get a paycheck. It's a very different attitude and very different style of doing the kind of work and is related to a lot of the things that we see.

00:29:25

So burnout is like Canary in the coal mine. And when I say that, it's because when you put a Canary in the coal mine, what happens if the Canary has trouble breathing, doing anything, then it's going to survive in that environment. What are you supposed to do? When it leaves? It's a warning sign it's of a toxic work environment. And what you do or should be doing is focusing on making the environment less toxic. But instead what we're doing with burnout, even though it's a sign of a toxic environment, people are often trying to make the Canary stronger and tougher and resilient. You can take any fumes in this environment. If you're just strong enough, et cetera, this is not the way to solve the problem of burnout. We've got to really be fitting people to the job. Training and education is one way. We do that and make that better fit.

00:30:29

We develop skills, practical experience. We teach people how to cope with stressors also good. Although one of them, the best ways to cope with work is to get away from it, which begs the question of what's going wrong with the job. They don't help make the job less toxic. These are, I think fitting the job to people is really the way to go. We modify the work conditions that create negative outcomes using ergonomics. How do we, we've been doing this for a long time, nothing new, the physical environment. We do better designs for, you know, assembly lines for seating, for whatever I've had graduate students working on pilot cockpit. So people don't make a mistake and hit the wrong button or pull the wrong lever. We can do that with the social and psychological environment as well.

00:31:22

So what we have found is if we look at psychological needs, what makes people tick? What makes them motivated? What makes them committed and innovative and so forth. And there are seven of them you can see up there, autonomy, belongingness, competence, having positive feelings and emotions at times, psychological safety, fairness and meaning all of these lots of evidence show that if jobs promote those kinds of things, you get a healthier workplace. So if we go back to those six areas, let's say, how would it look like sustainable workload, having choice and control over what you do, getting appropriate recognition and reward, having a supportive work community. It doesn't mean you always agree, but you figure out how to work together to solve problems and move on. Fairness, respect, social justice. What are the kinds of things that make that happen? Clear values and meaningful work.

00:32:28

So these are the kinds of, you know, if you think of those areas of the negative ones, but how, what would they look like? Here's one sort of cath and how can we begin to build this quickly as success story? This is another organization, not healthcare, not tech, but in the beginning, when we worked with them and we assessed, it was almost a thousand people in this organization. So what you're seeing there are the mean scores on the six areas, workload control, rewards, community fairness, and values. And the CEO thought workload and rewards were going to be the big negative issues. Very surprised to discover it was values and fairness. He said, oh my gosh, people think we're not a fair organization. We have to do something about this. And they did. They found all kinds of things that people, the employees felt were really unfair.

00:33:22

They made changes. One of the worst was a distinguished service award came with a extra bonus, you know, paycheck, uh, and people hated it because it was so unfair who got that award. And so a year later after they had taken that award apart changed, it got everybody in the company to really say, okay, now we're doing the right thing a year later, when we came in and assessed it, those six areas turned around fairness in particular, but look at the spillover effect that it had on everything else. And this is a very common kind of thing. So fairness was the issue, how we do things here is really, and we can make positive changes. This organization was one of the first that I worked with in partnering on research and consulting. And they have continued to do this process on their own ever since then, because it has worked so well for them as an annual process.

00:34:26

So six strategic paths, many possibilities, all of those areas to improve a good fit between people in their job. And the good news is that you don't have to do big, huge, expensive things. You can make small changes, small, inexpensive, customizable important thing is that one size does not fit all. And secondly, you really have to get input from the people who are going to be doing this and carrying this out. So it can be done with teams. It can be done with groups, units, but it's that social thing of saying, what would make this job better within this area? Can we try it out and see what happens?

00:35:11

And if the great thing about doing these changes like this organization on fairness is that it builds a sense of optimism and hope. If we could do that, get rid of this awful thing that everybody hates and actually come up with something good. Think what else we could do. And people talk about the pebbles in their shoes. The things that are, you know, are difficult or irritating get in the way you can begin to make changes there and create a healthier environment so that people are really thriving and growing in that. So final note burnout shop is not a viable. I don't think it's a desirable future for our workplaces. Uh, we have now at Berkeley, UC Berkeley, an interdisciplinary center that is bringing together people from all kinds of areas to talk about what makes a good workplace, a healthy workplace, where people are thriving, growing, developing, doing good work.

00:36:15

Um, so I'm learning a lot from architects and from medical doctors and public health. And they're learning hopefully psychology from me and others. Um, and we are really undertaking a challenge to say, how can we come up with better guidelines for what are ways to think about designing places where people are really going to thrive rather than being beaten down. So what's the help I'm looking for. I would love to get more examples of success, stories of the kind like the organization, you know, that's tackled fairness and figured out how to do it a lot better. Um, and also through the center, how can we establish better partnerships between research and practice? We now work with different organizations, different companies in the, in the bay area, San Francisco bay area, uh, right now, but we can go anywhere. And I was just in Norway last week to do some work there. And we really want to be able to partner in a way to say, how can we develop new solutions, try it out, actually get evidence on what works, what doesn't, what has potential and how can we then help broadcast that out to a lot of other people and a lot of other organizations so that we can really beat burnout, make it less and less of a problem and build a lot more of engagement in the workplace. So thank you very much.