Speaking of Psychology: Why we’re burned out and what to do about it, with Christina Maslach, PhD

The word “burnout” has become ubiquitous—it seems to sum up the stress, exhaustion, and disaffection that many of us are feeling this year. But are workers more burned out than ever? And what does the term “burnout” actually mean? How does burnout differ from fatigue or stress? How do you know if you’re burned out? And what can individuals, employers and society do to combat workplace burnout? Christina Maslach, PhD, answers these and other questions.

Christina Maslach, PhD, is a professor of psychology (emerita) and a core researcher at the Healthy Workplaces Center at the University of California, Berkeley. Professor Maslach pioneered research on the definition, predictors and measurement of job burnout. This work is the basis for the 2019 decision by the World Health Organization (WHO) to include burnout as an occupational phenomenon, with health consequences, in the ICD-11. She created the Maslach Burnout Inventory, the most widely used instrument for measuring job burnout, and has written numerous articles and books, including “The Burnout Challenge.”

Kim Mills: We've all seen the headlines. The U.S. workforce is burned out. Every week seems to bring another survey. Sixty-nine percent of frontline healthcare workers say they feel burned out. Twenty-nine percent of all remote workers very often or always feel burned out at work. Teachers, tech workers, veterinarians—name the profession, there's probably a news story about how burnt out its practitioners are. Even young content creators on social media are, “burned out and breaking down," according to a New York Times story published in June.

The word “burnout" has become ubiquitous. It seems to sum up the stress and exhaustion and disaffection that many of us are feeling this year. But are workers more burned out than ever? And what does the term “burnout" actually mean? How does burnout differ from, say, fatigue or stress? How do you know if you're burned out? And what can individuals, employers and society do to combat workplace burnout?

Welcome to Speaking of Psychology, the flagship podcast of the American Psychological Association, that examines the links between psychological science and everyday life. I'm Kim Mills. Our guest today is Dr. Christina Maslach, a professor of psychology emerita at the University of California, Berkeley, and one of the world's foremost experts on occupational burnout. In the early 1980s, she developed the Maslach Burnout Inventory, the standard tool used to measure job burnout. Her work helped lead the World Health Organization to recognize burnout as an occupational phenomenon in its 11th edition of the International Classification of Diseases in 2019. Over the past year, she's also offered her thoughts to the news media as an expert on the COVID-19 pandemic, job burnout and work life. 

Thank you for joining us today, Dr. Maslach.

Christina Maslach, PhD: Oh, thank you. It's a delight to be here.

Mills: Let's start by defining job burnout. A lot of people seem to think it's synonymous with stress and exhaustion, but burnout has a much more precise definition than that. So what is the difference between burnout, stress, exhaustion, depression? And is it a medical diagnosis?

Maslach: First, to begin with, it is not a medical diagnosis, and the World Health Organization made that very clear. It said it is not a medical condition. It's an occupational phenomenon. So it is a stress response. Exhaustion is, in fact, part of the burnout response. But it goes beyond the stress of responding to chronic job stressors and involves two other components. One is an increasingly negative, cynical, hostile response to the job, to the work you're doing. “Take this job and shove it," which leads to people not doing the job well, doing the bare minimum, rather than their very best. And it also includes a negative sense of self, and how your professional efficacy—“maybe I'm not really good at this. Maybe I made a mistake going here." So it's those three components, the stress response of exhaustion, the negative response to the job of cynicism, and the negative response to self, of inefficacy.

So, it can be a step in the path towards other kinds of problems, like depression or anxiety, but it is a mistake, I think—and the World Health Organization agrees on that point and says that it's not a medical diagnosis. So it's not something that should be treated in that way. And it is not identified within the DSM, for example, because it's more a human condition or response to stressors.

Mills: So, how is it different from just plain old stress and exhaustion?

Maslach: Well, exhaustion is part of burnout, so it's not different from that, but it includes more than just exhaustion. We will see people who have exhaustion, because they have way too much to do and can't possibly meet all the demands and all of that kind of thing. But they still like their job, they're, they feel good about what they're doing, they still feel good about themselves and how well they're doing. They're just really tired and it's just hard to keep up. So that's what we call an overextended profile, but it's not burnout, which is a high frequency of all three things, exhaustion, cynicism, and a lack of professional efficacy on the job.

Mills: How do you think the pandemic has affected burnout? There've been a lot of articles about the term burnout during the past year, but does that reflect reality? Are people more burned out than ever?

Maslach: It's a little hard to know exactly in terms of actual data and research data. People talk about it, analyze it, complain about it, but we, we don't have basis of evidence beyond this self-report there. For some people, in some occupations, yes. I think healthcare, which you mentioned earlier, is one good example. Teachers in schools might be another one, where the pandemic really changed their job and the conditions under which they were working. And so, that really just made it much more difficult for them to do their job well. The demands, the workload went up. The exhaustion was going up, but we were also seeing problems with the rest of the burnout response. So there are some places where yes, I think that's true. But to the extent that burnout sometimes gets overused to mean all kinds of things beyond stress response to job stressors, there could be other things that were happening in people's lives that would lead them to be experiencing stress. And so, for some professions I would say, yes, that was the case, but in other cases, I don't think that was happening necessarily.

Mills: Well, putting aside the pandemic, what are the risk factors for job burnout?

Maslach: To go back to the World Health Organization's statement, it's a response to chronic job stressors that has not been successfully managed. And so, what we're talking about here is a high frequency of these stressors. It's not something that people experience occasionally or only a couple of times a year. They're facing it daily, they're facing it on regular high frequency. And so, the chronic nature of the job stressors is really what's critical here. The successfully managed can be done by the individual, but often, really, is done by the unit, the team, the work group, the organization, the occupation. World Health didn’t designate it as being managed by just the individual. And what the research data really supports is the notion that it's really the relationship between people and their job, whether there's a good match or fit or a mismatch, that really is problematic and raises the risk of burnout.

And so what we have found in the research is that there are at least six major areas in which a mismatch between the job and the person, the work and the worker, are critical. So the one everyone thinks about of course, is workload, where the mismatch is high demands, low resources. Lots to do, but not enough time or people or tools or information to get it done.

But there are five others. And sometimes those are more important even than workload. There's control. How much choice, discretion, say you have over what you do to innovate or do a little better or differently. Or are you—don't have a control over the work that you're doing. And that's a huge one. A third area is a mismatch in terms of reward. And it turns out not so much pay and perks per se, but recognition for having done something well. And getting those kinds of social and intrinsic rewards of doing a good job.

Fourth area is what we call community. And this is the workplace community. Who are the people that you are in regular contact, interaction with? Your colleagues, your boss, people you supervise, the customers or your clients or patients. Depends what it is. And are those relationships in that workplace community supportive in figuring out how to work out problems and do things better, or is it a really toxic environment where you feel that you're going to be bullied or treated badly or kept out of things and all of this kind of thing? So people talk about it as a socially toxic workplace in that case.

Fifth area has to do with fairness, sort of basic human need to be treated fairly in whatever the system is, whatever the problems are. Being treated unfairly, this is where we talk about glass ceilings or discrimination or people getting ahead by lying and cheating rather than actually deserving of something. So being treated unfairly really keeps you out of the workplace community. It makes you feel really disrespected, and that can lead to a lot of the cynicism that we see with burnout.

And finally, the sixth area has to do with values and the meaning of the work and the pride you take in doing it well and contributing something. And that you're not in an environment of conflicts or ethical behavior, or you're being asked to do things that you just feel are not right or are wrong in some way. And so it's those six areas—workload, control, reward, community, fairness, and values—that are the kind of six drivers at this point that we know of that hold risks for burnout.

Mills: Can individual workers determine if they're experiencing burnout, or is this something that really has to be measured objectively by the employer or an outside consultant, for example?

Maslach: Quite honestly, I have never heard people say, I don't know what burnout is, can I take a test? It's like this medical diagnosis again, which is really wrong. It's a stress response. And people usually, if they think about their own experience, know—am I exhausted and feeling stressed? Am I beginning to get really sour on the job and really hate it and don't want to go there and dislike it, et cetera, but I'm stuck? And how do I feel about how well I'm doing on the job?

I don't think it's a mystery in this way. The measure that I developed is a research measure, it's not a diagnostic tool. You develop it so that you're sort of assessing how often do people—how frequently are they experiencing these three aspects of burnout? And what does that correlate with, or how do we discover other things about causes of burnout, effects of burnout? The kinds of occupations that pose higher risks.

So it's a research tool, but that doesn't necessarily say that you can only know it if you take a test. And it shouldn't be used for diagnostic purposes. It should not be used ethically against people's will. I've seen organizations where they'll post names on the wall, or they'll tap people on the shoulder—it's not confidential or anonymous—and say, oh, I think maybe you're burned out. You've got a problem. You better go see a therapist. This is not the way to go to assess burnout and find out, do we have a problem here? You're looking at the aggregate. Where is it showing up? What percentage of your workforce is like that? But it's not to go after the individuals and essentially figure out how to fix them or fire them.

So there's some real confusion, I think, around some of this. The other thing is that there's more to people's experience than burnout or not. We've identified in research at least five different profiles ranging from engagement on the more positive end to burnout on the more negative, and three others in the middle where people are showing maybe one of the burnout components, but not the full three. The high frequency and response to chronic job stresses.

So there's a lot more to it than just that. But I think people are concerned about what do you do and how do you handle it? And one of the problems there, I think, the challenges, is that people tend to focus on what's wrong with the person and then how do we fix them or help them cope or whatever, rather than looking at the other part of that mismatch, which is the job conditions and the workplace. And that has to be fixed or changed or improved or whatever. It's not just focusing on who are the people who just can't handle this?

Mills: What are some of the best practices for a workplace where management thinks that employees are experiencing burnout? What do they do? Do they survey employees? You talked about collecting data in the aggregate, but do they also meet with individuals? What should a company do if they think that their employees are burning out?

Maslach: Well, basically burnout works—it's a signal that things are not going well in the workplace. And it's not just about what's wrong with the people and how do I work with them, but to work with those employees on how could the workplace be made better? How could we improve the situation that they're facing?

And so I think it needs a different kind of a dialogue that really focuses on where might there be some of these chronic job stressors, the pebbles in your shoe you're experiencing all the time? And using those six areas of mismatch as a guide, where could we begin to change the way we're doing things in terms of the control or the workload or the recognition or the community or something like that? And so, it has to be more of a collaborative process, I think, to focus on what might be the problem areas and how can we go about making positive improvements?

I don't think it needs to have a survey, but there's another point that I think I would make here, and that is that even though there's a lot of discussion about burnout, it's still perceived and treated in a stigmatized way. So trying to find out who has burnout and how much burnout and how much of a problem is burnout. People are often unwilling to answer that truly, honestly, in that if they think there's going to be a downside on that, like that tap on the shoulder saying, “What's wrong with you? You better see a therapist.” Because it is that kind of stigma and there could be negative consequences of it.

So taking a focus, not on, “Do we have to have people self-identify as burned out before we do anything to improve the workplace?” No, we can start improving it and if there's anything we've learned from the COVID pandemic is that the workplace can be done differently. We've had to do it all year and some things have worked well, other things have not, but it can be different. And so let's really think out of the box and try and figure out how do we make a better, healthier environment in which people can thrive rather than get beaten down. And that does not require any sort of sign of burnout per se, before you do that. But that burnout really tells you more about what's going on in the workplace than what's going on in the individual.

Mills: There've been a lot of surveys in the past year and a half that found parents of young children have been extraordinarily stressed trying to balance their work and childcare. Do outside stressors like that contribute to occupational burnout?

Maslach: I think for some people, they argue that there is such a thing as parental burnout and other kinds of burnout. They're using the same kind of stress analogy there. But yes, certainly to the extent that you have other things going on in your life that make it more difficult to do the job well and to be in good shape and your own health and well-being, and being able to take care of your family and all the rest of that. That can certainly add to the whole burden. There's no question. So that kind of mismatch between the workload and the rest of your life can be huge as we saw. There also can be positive things that have happened with the working from home thing for some people, don't have to commute the way they used to have to do that. Or maybe they have access to other resources where they can do their work better or some of it on a different timeframe. So I think there's a lot we still need to learn about different possibilities for different kinds of people in different kinds of occupations.

Mills: So you've written about the fact that people tend to think of burnout as an individual problem and it's something that needs to be addressed by the person who's experiencing it, but it's actually the workplace problem. It needs to be solved at the meta level. Can you talk about that a little bit?

Maslach: Yeah. I mean, this is what I am talking about in terms of the relationship between the job and the person, that using an either or thing, is it the job? Is it the person? When the answer really is it's both and you need to really think about what is happening in terms of those chronic job stressors that are there most of the time, all of the time that are just wearing people down. And how do we make changes there as well as helping people to relax and cope and all that kind of thing. But a lot of those chronic job stressors that people are responding to, or trying to deal with, are ones over which they have no control and can't be changed, or it shapes how they're able to live their life and do their day or night hours or whatever shift they're working.

And so there's always a bigger, better approach to this. And it's not just by individual jobs. It's also about how do we make assignments? How do we decide how to get X done, as opposed to Y? If we're adding more to people's plates in terms of the work they have to do, what are we going to subtract? What is no longer as necessary. To simply say, "Sorry, we just have to do more with less,” which is what we're hearing a lot, is just an overload phenomenon that is found to cause more stress for more people with all those negative consequences. And so a real solution is not simply to say, “If you can't take the heat, get out of the kitchen.” It's like, “Okay, we'll help you cope and do better in this kind of environment, but we're also going to work on the kitchen to make it a better place to do that kind of work.”

We have to look at both. I mean, burnout in that sense is like the canary in the coal mine. The canary goes down, if the canary's having problems operating in the coal mine, it's not that something is wrong with the canary, that it's not tough enough, tough little bird. It's that it's toxic fumes and it's a signal that something needs to be fixed before everybody else goes into the mine. So that's for me, burnout is really more of that signal. It's saying, “It's becoming too difficult, too much, with too many negative consequences for not only the workers, but the people they deal with, their family life, and so forth.” And we have to address both.

Mills: A recent Washington Post story talked about some of the solutions that companies are trying to implement to combat burnout. And some of them are offering an extra week of vacation time, others are shutting down for a week so everyone has to take time off. Some employers are offering flexible schedules and some are experimenting with a four-day workweek. Are these good ideas? Do they effectively combat burnout? Or is there something counter-intuitive about trying to solve burnout by telling people to get away from the workplace?

Maslach: You hit it right on the head. I mean, it's a strange thing, but often the best way to cope with work stress is not to work. And that begs the question, what's wrong with the work that to deal with it, you have to get away, take time off, take a vacation, do fewer hours, all that kind of thing?

So there's a distinction I think that's important to make here between coping and prevention. Coping by getting away in some way, fewer hours, take a vacation, a week off from work or something like that, take a vacation is coping with stressors, but it's leaving the job as it is. And if it is what it is, then when you go back, those stressors are still going to be there and it's still going to be the problems that were leading to the burnout in the first place.

So to prevent, to actually change the likelihood that burnout will occur is you want to somehow begin to make changes in the conditions that are causing the problem of burnout. So those chronic job stressors. If you just leave them in place, it's not making a difference. And we see in other research on the value of vacations, and getting away, and so forth, there's always an initial good thing. You feel better, you come back saying, “Oh yeah, now I'm ready to go to work.” And pretty soon it's all back to where it was and it's not good. So, it's a coping strategy, but it's not really dealing with the problem, which is, what are the chronic job stressors that are causing the difficulties for everybody?

Mills: What about workplace wellness programs? Things like offering yoga, or meditation, or paying for employees' gym memberships. And I know Amazon recently got some criticism for installing a Zen booth meditation kiosk in its warehouses without really doing anything else to change the working conditions. But do any of these wellness programs address burnout?

Maslach: No, not really. I mean, again, they are all pretty much coping strategies. The job is what it is. You're still in the warehouse doing whatever, but we have this thing over here and maybe that will help you feel better if you use it and take some time off, and all of that kind of thing. So again, it's a coping strategy, but it's leaving the job conditions as they are.

So, the other thing about wellness strategies, I think a lot of them can have a positive effect. There's a huge self-care industry out there with all kinds of ideas and possibilities for helping people to cope, and be more healthy, and all that kind of thing. But tell people to be more healthy, and relax, and make sure you get your eight hours of sleep a night, and so forth, when you are in overload, and you're taking work home, and it's disrupting your family life and your sleep, et cetera, that's not going to help. You have to change those other job conditions.

So, the other issue about wellness strategies, that I think I just want to point out, is that in many cases, the ideas are good, but they sometimes are badly implemented. So, you're telling people, you must do X, but not on company time, or some sort of thing like that. The other part of not doing it well, implementing it, is that I'm surprised how often the employees are never asked if this Zen booth would be a good thing. If they could have a choice of what would happen that would make life better, what would be the things they would really like to see. And so much of this stuff, essentially, gets implemented top down without getting input from bottom, side, whatever, as to what would really make a difference.

And so, I've seen all kinds of wellness things that don't get much uptake. I mean, people don't do them that much because it's really not the kind of thing that is helpful to that. It doesn't fit well within the kind of job they're doing, and so forth. And, you really need to check, of all the many solutions that might be out there that will help people and make them feel better about doing the job, you've got to check first whether this is something they really want. I have seen things that are wonderful. Volleyball courts on the roof of a building unused because nobody wants to, and can't get off work to go and do that. And you need a team and all those kinds of things. So, it's just not well thought out.

And so, we see a lot of things where the intention is good, but the implementation is not. And it rubs people the wrong way. They're being treated in a very paternalistic way as though you don't know anything better, we're doing something good for you, so go do it. And often it's,  “And by the way, you're going to lose some weight. Okay. And maybe stop smoking,” and all that kind of thing. So, they're being talked down to, and I think that somehow also doesn't help them realize that maybe some of what's being offered could actually be useful. But there's often a mismatch there of intension. Oh, here's a good, healthy thing. And can people actually use it, and it doesn't make a difference. Is it worth the money? Is it worth the investment? Any good return it? Not so much.

Mills: Well, this has been really interesting, Dr. Maslach. I really appreciate your joining us today. And I hope our listeners have gained a greater understanding of what burnout is and isn't, and how to deal with it. Thank you.

Maslach: Thank you so much. I really appreciate the opportunity that APA gave me to talk about this.

Mills: You can find previous episodes of Speaking of Psychology at www.speakingofpsychology.org or on Apple, Stitcher, or wherever you get your podcasts. And please, if there's an opportunity, leave us a review. If you have comments or ideas for future podcasts, you can email us at speakingofpsychology@apa.org. That's Speaking of Psychology, all one word, at apa.org. Speaking of Psychology is produced by Lea Winerman. Our sound editor is Chris Condayan. 

Thank you for listening. For the American Psychological Association, I'm Kim Mills.