Better Being Series: Understanding Burnout in the Workplace

Intro:
Hi everyone, and welcome to the award-winning “On Aon” podcast, where we dive into some of the most pressing topics that businesses and organizations around the world are facing. This week in a special series on resilience called Better Being, we hear from Rachel Fellowes, Aon’s Chief Wellbeing Officer, with her guest, Christina Maslach, on resilience and assessing burnout. 

Rachel Fellowes:
Hello and welcome to Better Being with me, Rachel Fellows. I'm the chief wellbeing officer here at Aon, and unsurprisingly, I'm passionate about wellbeing and human sustainability in the workplace. 

Globally, an estimated 12 billion working days are lost every year to depression and anxiety at a cost of over 1 trillion U.S. dollars per year. As a result, wellbeing has quickly moved to the top of company's priorities lists, with 83 percent of companies now saying they have a wellbeing strategy in place. How organizations prioritize and integrate wellbeing can have a profound impact on employee engagement, talent recruitment and retention, as well as overall business results. So, it's more important than ever to get this right.

And a wellbeing strategy can include individual wellbeing components like physical, emotional, social, financial and career elements, as well as considerations around team and organizational sustainability. And in this series, I take a look at what makes for better being at work with thought leaders and subject matter experts.

Currently, only around 30 percent of employees identify themselves as resilient and burnout is on the rise everywhere. The Gallup study in 2020, a date you may all remember well, found that 76 percent of employees experience burnout at least sometimes, and 28 percent report feeling burnt out very often or always at work.

An Aon's 2021 Global Wellbeing Survey identified burnout as a significant concern among employees. Burnout, along with work-life balance and mental health issues, is a major wellbeing risk and one that impacts company performance globally. A 4 percent improvement in employee wellbeing can lead to a 1 percent increase in company profit and a similar decrease in employee turnover. So, trying to understand how to prevent and manage burnout is not only the right thing to do, but it has a real impact on the bottom line.

So as a leader as well as a wellbeing officer, I'm therefore particularly pleased to have Professor Christina Maslach as my guest on this episode of Better Being. Now, Professor Maslach is a distinguished psychologist and a pioneer in the field of burnout research. I studied her work when I was doing my masters. And she's a professor emerita of psychology at the University of California Berkeley, and has dedicated her entire career to understanding the causes and consequences of burnout.

Her groundbreaking work includes the development of the Maslach Burnout Inventory, which is the most widely used tool for assessing burnout across the world. Professor Maslach has also authored several influential books on the subject, including her latest one titled The Burnout Challenge: Managing People's Relationships With Their Jobs. Her insights have been instrumental in shaping how we address burnout in the workplace today. So, it's with that, Professor Maslach, that I welcome you and I look forward to our conversation.

Christina Maslach:
Well, thank you so much for inviting me, Rachel. I'm pleased to be here.

Rachel Fellowes:
I know you are very well-educated on this topic, but could we assume that many people, including myself, are not? So, I'd love just to go back to the basics and start off with a question like what is burnout? And in particular, I read somewhere that the World Health Organization actually classified it as an international disease in 2019. So, is it that or is it something else? So, in particular, I'd love to explore the medical illness side.

Christina Maslach:
Well, yes. Well, let me first just correct a little bit. The World Health Organization made it very clear it is not a disease, it is not an international disease, and it's listed in their international classification as an occupational phenomenon or experience that can have health consequences down the road. But in and of itself, it is not a disease.

It is actually a stress response, and that's a response to some sort of stressors. We have a stress response all the time to different kinds of stressors. This one focuses on chronic job stressors in the workplace. And World Health also said that these chronic job stressors are things that have not been well managed. And so, an important part of that definition, which I completely agree with, is that people are responding to chronic job stressors. And we know that any kind of chronic stress, which means it's there all the time, most of the time you can't get away from it somehow, we do not cope well. We do not recover well from experiencing chronic stress.

So, the stress itself is a perfectly normal experience. All human creatures have a stress response. There's threats out there, there's challenges out there in our body, mind. Everything kind of has to get into gear and deal with it and then recover from it. It's not supposed to be a normal everyday way of living. It's used for a specific kind of purpose. So, it's not a pathology in and of itself, but it's the recovery or the lack of recovery or the poor recovery afterwards that really becomes the problem.

So for me, what we have found from the research, and I didn't sort of make this up out of nothing, I interviewed a lot of people, I observed, we did a lot of work to try and identify what it was that people were experiencing back in the 1970s is when I started this. And there are three interrelated components of that occupational phenomenon, that occupational experience.

One is the exhaustion of stress. When you're completely stressed out, you're exhausted, you're tired, you can't get up and do the next thing. I mean you're just wiped out. So yes, it is a stress, a response to chronic job stressors. But two other things happen with burnout, which make it sort of distinct as from responding to other kinds of stresses in our life. And that is, one, that we begin to have a very negative, cynical, hostile reaction to the workplace. "Take this job and shove it." According to a country Western song is what we're all about. And people are thinking, "Why am I here? I don't like the people, I don't like the job. Can't they do the things better? Maybe I should have done something else." All of this kind of thing.

So, for me, that's really the hallmark of burnout because it means that how you're doing the job, how you're doing your work, you're switching from doing your very best to doing the bare minimum. How can I get everything done and get out of here and still get my paycheck kind of thing. So, the quality of the work, whatever it happens to be, whether you're teaching, whether you're providing healthcare, whether you're working in a tech firm, you're in a bank, whatever, you're not really doing the best. You make more errors, there are more problems. You are out on sick leave, all kinds of things.

The third component that comes in is that you begin to feel not just negative about the job, but negative about yourself. What's wrong with me? Why can't I handle this? Why am I doing this job? Maybe I should have done something else. I'm not proud of what I've done, et cetera.

So, it's that trifecta of exhaustion, cynicism, and a feeling that I'm not really very effective in this work. And it's those three together that comprise the burnout experience because you're just burning out on the job and the work you're doing and you're feeling not good about yourself.

Now, all of that, as we know from decades and decades of work on from all kinds of people, even before my time, on stress and coping, what we know is that not coping well with stress, not being able to recover well and so forth, means that you're going to have health consequences over time. We know when people are working too much and too hard and so forth like that, they're going to be at more risk for cardiovascular heart problems. They're going to have more stress injuries and back problems. They are going to perhaps develop depression or anxiety about things are not going well at their work. And so those are the kind of health consequences that World Health has pointed to and said that we need to understand and recognize job burnout as a phenomenon that happens and can happen in the workplace because it has these health consequences on there.

So that's really what burnout is all about. But for some reason, and I can't always say why this is true, people keep thinking it must be a disease, it must be a mental illness. Why isn't it listed along with depression and other things as get a number and stuff like this as a mental illness? And it's not. It can be a difficult experience for sure. People will quit their job and leave, they won't do it well. But it's not because there is something internally wrong with them in terms of a disease, it's that they are coping or trying to cope with chronic stressors that are not going away and are not getting moderated in some way.
Now, World Health did say chronic job stressors that have not been well managed, and there's an optimistic note there. They could be better managed. They could be different. They don't have to be chronic and really having this negative effect on people. So, for me, what's important is that focusing on burnout as a disease means you're asking who is burning out and you come up with who answers. Oh my gosh, what are we going to do with that person? They're going to have to see a psychiatrist, they're going to have to see a doctor, they're needing some medication, maybe they have to have a vacation time off and then come back and all that kind of thing. And actually, that's saying, "Can you help people cope better?" But if the job, this chronic job stressors are getting so bad that people are experiencing this, you want to ask a different question, which is why are people experiencing burnout, not who. And when we say why, we start looking at what are those chronic job stressors. How could we better fix the job, not just fix the person?

Rachel Fellowes:
So, Christina, that's phenomenal. I've never actually heard it laid out in three simple facts like that. And curiously, as I was listening to you, I scribbled down twice, "Not well managed." I love that phrase. And so maybe we can now go on to another reason why you're so famous, but the Maslach Burnout Inventory, the six particular areas that are a focus for that. So, could we just take everybody through them please?

Christina Maslach:
Okay. Well first, the MBI, Maslach Burnout Inventory, was a research measure that I developed along with Susan Jackson and was first published back in 1981, so it's been around for quite some time. And it captures not the six areas, it captures those three dimensions of the burnout experience. And in fact, it was the research that we did there that led us to identify that there were three interrelated components rather than just a single one. And it came out of that research.

So it measures the exhaustion, it measures the cynicism, it measures the sense of professional efficacy, and it measures them in terms of questions which people ask and answer in terms of frequency. So, it's not a yes, no, I agree, disagree. It's how often do you feel like this? How often do you experience this kind of thing? Like I can't get up, don't feel like I want to get up in the morning and go to work.

And so, when we talk about a chronic kind of response, we're talking about people are saying every day or most of the time I'm feeling like this. And for people who are not experiencing burnout and are engaged with work, it's not that they don't feel stressed sometimes, but the frequency is much lower. This only happens occasionally or maybe they recover better from it, that kind of thing.

So, the MBI assesses those three dimensions of burnout. And what we've been able to do over the years is look at the patterns of those three components so that we see in a sense different patterns or profiles that people can experience and change and move back and forth. So, on the far negative side is burnout. They're high frequency on all three negative components. On the opposite, they're engaged. All three components are low frequency, so they're exhausted only occasionally, et cetera.

And then in between are three profiles or patterns in which they're beginning to show one of those three problem areas. The one that's most common in some sense is what we call overextended. And that means you are high on the exhaustion, you are tired, you are worn out, you have way too much work to do, and you're scrambling to do it, but you still like your job and you still feel good about the work you're doing. So, you're only showing a problem on the exhaustion, the stress thing. People think, "Oh, well, that must be burnout. You're tired and exhausted." And I'm saying no. Burnout is when you hate the job and you're really questioning yourself as well. So, if you're still feeling good and stuff, but oh my god, this is so much work, it's overextended.
Similarly, there are people who have a very negative cynical response to the job. They don't like how it's being run and what they're doing. They're not particularly exhausted or stressed and they still feel good about themselves being able to do the job, but they are really negative and they are the disengaged. They're pulling away from the workplace. And then there are people who are doing fine, not stressed, like the job, but are saying, "I don't know, I don't really feel so great about it." You don't get much positive feedback. "Does anybody know I'm here doing this?" This kind of thing.
So, there are these different profiles that we can assess using the MBI. Again, people who assume it's a medical disease assume this is the way to diagnose it as though you were recording a temperature with a thermometer. It is not a disease, it is not that kind of medical assessment. And people don't necessarily need the MBI to decide am I experiencing burnout, that kind of thing.

The six areas is from other research where what we have done with the MBI is collected data on people in different workplaces, in different countries and collected other information about where they're working, who they are, what kinds of challenges they have in the workplace to get a better sense of when does burnout show up more often or not. So just quickly, the six areas we're talking about the areas of the extent of a match or a mismatch between the job and the worker, the employee. And we're looking for a better fit so that the person has the training and the capability to do the work, and the work conditions are ones that are clearly helping to support the person get the job done well and on time and so forth.

So, six areas, the one everybody thinks of first is workload. And the mismatch here is when you have high demands of things that need to get done, but low resources. There's not enough time, there's not enough information, not enough staff people, you don't have the proper equipment, whatever it happens to be. So, trying to get the job done on time is going to be very difficult. So, when you have a work overload, that's when you're having a mismatch of that kind.

We often find that it's not just the workload, but it's how much control, that's the second area, how much control you have over the work. Do you have enough independence, discretion, autonomy to make changes, to course correct when something comes up unexpectedly? Can you innovate that kind of thing or are you locked in, there's only one way you can do this, and you cannot deviate from that? So sometimes it's the uncontrollable workload that is more of the problem area there.

The third area we call reward, it's really about positive feedback when you do the job well. And so, it can involve things like salary and benefits. But more importantly, we have found that social reward, recognition, people notice that you've done a good job, thank you, are grateful, come to you for help, pat you on the back, whatever that kind of thing is so that you're getting as you work and do your work, you're getting periodically feedback that, yes, you're doing a good job and thank god you were there and handle that difficult situation kind of thing.

Fourth area is what we call community, meaning the workplace community. Who are the people whose paths you cross on a regular basis? So, these are colleagues, people you supervise, your bosses, managers, your clients or customers. What we find here is that if that workplace community has relationships with a lot of trust and support, if we disagree, we can figure out how to come together and get on the same page and move forward, support each other.

If you have a mismatch in community, you have got things like harassment and bullying and people not being available to help each other out or willing to do that. You don't know where to turn. You could be surrounded by a lot of people in the workplace, but you don't know who you could talk to if you needed advice or if you were having a bad day and just wanted to cry on somebody's shoulder because they might put you down, they might throw you under the bus. It would not be good in that sense. And people have been calling this socially toxic workplace. It's not just the physical things that might be dangerous, but other people are in fact a threat to you rather than a source of collegial friendship.

Fifth area is fairness, and basically we find that everybody really wants to be treated fairly no matter who they are or what kind of job they're doing. That whatever the rules are, whatever the policy, whatever the rewards that are doled out, that they're done fairly rather than favoritism in the workplace. This is where discrimination glass ceilings exists, where no matter what you do, you are not getting the right kind of fair treatment that one would expect.
Sixth area, last of the six, is values. Other people sometimes call this meaning or purpose, but basically this is why am I doing this job? What is it that's important? Why do I think this is something that I'm making a contribution that I believe is good, that I'm contributing in some sense? So, whether it's you're teaching and you're getting young students, young people a good start in life because you're a good teacher, if you're helping somebody recover well from illness or injury, whatever that happens to be.

And when people are working in a situation where there are value conflicts, where there are unethical issues and you're being told you can't say that, you can't call out something that's wrong because that would give a bad name to the company, or if you're in healthcare, you have to do really difficult things that they call moral injury, it's just very, very hard to keep doing. You feel like you’re losing your soul in some sense. So, this is when people really feel that the values conflicts are too great to deal with, they're more likely to quit and just leave and say, "I've got to find something else. I can't keep doing this in my life."

So those are the six that we find that if those kinds of mismatches exist in the workplace, then what you really want to do is it gives you kind of six areas to kind of look at where can we make things a little better around here? How can we begin to modify some of those chronic job stressors? And it's not just workload and it's not just pay. It's actually some of these other things as well. And what we really recommend on the basis of the research is that there be some regular checkup annually. Just like when you go to check up and see how your health is, check up on how we're doing. And rather than saying, "Who's burned out? Who's having more problems with the workplace?" Just say, "So what's working well? Great. What's not working so well? And what could we do this time to make that a better thing?"

Rachel Fellowes:
That's absolutely fascinating. I think what's also really interesting is you are saying it's the balance between six things. It's not just about putting all the weight onto one. We're using the language of burnout a lot more. Are cases of burnout actually on the rise? And as a result, if you're sitting in my position, anyone who works for an organization, anyone who has interest or influence as a manager, as a leader in the wellbeing and the sustainability of their people, what one thing have you noticed works most in light of the current environment we're all in?

Christina Maslach:
Well, there's two. Let me just make a distinction between coping and prevention. And they're both good. I'm in favor of both. But I think we're doing a lot more focus on coping because we think it's an individual thing and we've got to somehow help people or teach people how to cope better. And coping is fine. And this could be you take time off, you exercise, you do get your sleep, you meditate, you get more mindful. There's a whole industry, quite honestly out there, self-care industry, which has lots and lots of things to help people cope with stress.

But coping doesn't necessarily change the source of the stress. So that chronic job stressors are going to still be chronic, they're still going to be there and you just have to be resilient, be stronger, cope, cope kind of thing. And at some level, I guess I have to say, if the job is getting more stressful, more demanding, going above and beyond what is normal for people in terms of their work, we should not honor it by coping with it. We should actually improve it and make it a better place. Get rid of some of these stressors or make them less frequent or help people cope better with them if we can't get rid of them in some ways.

But we need to be in a sense mindful that the idea of working harder and harder and getting more and more stressed constantly is not the normal way human beings live. And we are forgetting why we are supposed to have an eight-hour work day and an eight-hour personal time and eight hours of sleep. That's the 24-hour cycle. And in fact, you need all three of those in that kind of rough approximate balance in order to be healthy, to recover, to do well. And if work is invading more and more of your personal time and your sleep time, then you're living an unhealthy life and the consequences will catch up to you later on in life. And that's what World Health is pointing out. This is something that has long-term consequences.

So, I think we just need to be more mindful of the fact that we need to improve the conditions of the job and adjust on a regular basis because the world changes and jobs will change. And we learned that big time during COVID because we had to change a lot of jobs. They couldn't be done in the same way. Sometimes the new things worked out well. Sometimes the new way of doing the job was a disaster. We have to learn from both what worked, what didn't, and sort of say, well, next year, five years, 10 years, the world is going to be different again. And how do we adjust what we're doing? What are the goals of the work we're trying to do, and how do we come up with the best sort of environment that supports that work getting done well, getting done on time, and being a source of pride for the people who do it?

Rachel Fellowes:
It's absolutely brilliant. I'm almost sort of hearing a couple of different layers, but I love this concept of accountability. So, what is in my control to be accountable for, and I loved what you were talking about, just even asking yourself that simple question. And then lifting up to the collective we.
That's it for our show today. Thank you all for listening.

Outro:
Thanks for tuning in to the latest episode of “On Aon” with our episode host, Rachel Fellowes, and today’s guest, Christina Maslach. If you enjoyed this episode, you can get more insights on resilience and burnout in the workplace and information on future podcasts by following Rachel Fellowes on LinkedIn. In the meantime, be sure to check out our show notes and visit our website at Aon dot com to learn more about Aon.