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Morality & Me - Episode 4: On burning out... and rebuilding

Credit: Rene Magritte - Mental complacency

On this journey through my career, looking at the ways in which matters of morality have played a part, I have so far shared stories and reflections about starting my career, my first specialist roles, and my experience of becoming a manager. In the big circle of professional life, like many others, these years of growth and development came at the expense of much needed self-care, partly due to expectations from roles and people, and partly out of self-inflicted negligent behaviours. In this article, I explore how morality comes into play when years of stretching myself at work led me to reach breaking point.

What do we mean by "burnout"?

First, let's have a look at how we can define burnout, for which research provides a few interesting perspectives. Measures have been defined to help assess burnout, and while I believe there are clear limitations in how much we can quantify certain phenomena, these measures help provide substance behind the concept of burnout, and how it is spoken about. Two of the main measurement scales (Maslach Burnout Inventory and Utrecht Work Engagement Scale) both use three indicators, with a good degree of similarity, whereby we can see that burnout is characterised by a sharp drop in energy levels, a detachment and negative feelings towards work, and a drop in performance. Another model called the job resource - demand model, expresses that burnout occurs when people are faced with significant job demands, and too few job resources to meet these demands. Interestingly, the word "burnout" has made it into the French language, where it is used as a noun ("le burnout") relating to the more extreme outcome of burnout, when people are overcome by the symptoms they experience, reach a state of extreme exhaustion and are unable to work. This use of the word actually gives more weight to the deep personal impact of burnout on one's physical and mental health, which can seem under-represented in some of the mainstream research.

Burnout and morality: moral injury

This is also where morality can feature when talking about some of the most serious experiences relating or contributing to burnout, in what is called moral injury. The concept of moral injury was first used in the military for war veterans, before being widely used to describe challenges faced by healthcare staff, especially during the COVID-19 crisis. It describes the long lasting impact caused by people witnessing, committing, or being unable to prevent acts which transgress their individual moral standards. It has been shown to lead to conditions such as PTSD, depression, and to burnout. It is easy to envisage what such situations might be for military personnel in war zones. In healthcare, some accounts of the experiences of doctors and nurses show some of the harrowing situations they found themselves in, when for example a lack of respirators meant having to make decision on how to prioritise certain lives over others. Journalists have also been studied for their experiences of moral injury and PTSD, particularly when covering war zones, an all-too familiar scenario at the moment.

Of course, I would not pretend that any of my own professional experiences compare, even closely, to any of these situations. Yet I do believe that I have, as most of us, often faced situations in my career where the demands of my role have made me transgress personal beliefs, and moral standards, to a certain extent, and that this has contributed to me reaching this point of burnout. The episode I refer to in my case when talking about burnout took place just under 5 years ago, although it had been in the making for, probably, the preceding 15 years. It isn't an uncommon story of getting into bad self-care habits for the sake of achieving what I believed was the standard of professional performance which was expected of me, and which I had come to expect from myself. The role that my childhood, education, and other social pressures had to play in gradually shaping this way of thinking is undeniable, although I won't expand on this here. For the best part of these 15 years, I had been up at 5am to either get on an early train try and beat traffic, for a working day in the office which would typically last until 7pm (with regular extra time in evenings and weekends). Equally damaging was the fact that work matters remained in my head 24/7. Occasionally, this would come from an enthusiastic place of thinking up new ideas, but more often than not it would be anticipating challenges ahead, wondering how I was going to achieve what I had set out to, etc. The trigger that eventually got me to reach breaking point, and have to be off work for a couple of months was multifaceted: the previous few months, I had attempted - for the last time - to come off the medication helping me to manage depression; at the same time, I had agreed to take additional responsibilities at work, with a global remit meaning that the work never stopped, international travel was involved, and a cumulative workload which, with hindsight, gave me no chance of success despite working all hours; this inability to perform as I aimed to, coupled with onsets of depression symptoms, and simply physical exhaustion meant I became unable to function, and taking time off became not a choice for self-care, but a necessity.

Micro-moral injuries

Back to what is also called "Potentially Morally Injurious Experiences" (PMIE), which I believe in this case have been contributing factors to my situation - although I am mindful that I am using this term for circumstances much less severe than what it would normally refer to. In fact, for me, it is more about a succession of what one might call "micro-moral injuries", which include the following examples:

  • Witnessing leadership behaviours which, while not infringing codes of conduct, fall short of your own moral standards; not being in a position to intervene, or getting anyone to do so, while trying to provide support to those affected

  • Having to take the "company line" when communicating or taking action on people related matters, even though it goes against your own personal belief - in the context of organisational change or people decisions, where people's careers and lives are impacted for example, or having to stand by claims which you do not believe to be genuine; effectively, all those times where your corporate identity is at odds with your deep personal identity

  • Having to let work commitments take precedent over other events in your personal life, where people close to you need your support, or feeling that you are not present, or in the moment, during times that matter, with family or friends

  • Deciding who you are going to let down on commitments or promises you have made, because too much has come in the way of you honouring all of them, despite your profound belief in keeping to your word as a basic foundation of trust

Once again I will stress that these examples do not pretend to compare with what a soldier experiences in a war zone, or a healthcare professional does when faced with actual life or death decisions. Using the analogy of physical injuries, it could be compared with the difference between breaking a limb, and sustaining a longstanding repetitive strain injury. In both cases, it is likely that people will require a form of rehabilitation period, which is what happened to me next too.

As is often the case, while my work environment was somewhat ill-equipped to prevent instances of burnout, it had a number of support mechanisms in place to provide support to people who go through these types of experiences. While, of course, I would have preferred not to have to resort to the, I was grateful for having access to them. Access to counselling helped me work on my more deeply-rooted personal challenges. In parallel, the occupational health consultant working for my organisation acted in a very supportive way to ensure I took the time necessary before even considering a return to work.

Healing and rebuilding

At first, I was expecting that the time off work would give me an opportunity to reconsider my priorities, reassess if, through what I was doing, I was living in line with my own values. The truth is, the time off was simply time for healing, for letting my body relax, after years of being so permanently tense that I wasn't noticing it anymore, and to start appreciating sleep again - for years I had convinced myself that five or six hours sleep is all my body really needed when, given the chance, I realised I could easily get used to a good eight-hour sleep, with a much better outcome on my wellbeing.

The real work of rebuilding, and rethinking what I wanted my life to look like and how I wanted it to be balance started when I eventually started my phased return to work. Even then, I envisaged that I would straight away make a number of changes which would get me in a better place, when in fact I realise now that all I did was kick-start a process which took me another few years, and a number of incremental changes, to get me to a place where I have re-ordered my priorities and taken steps to live more in tune with what my true self values - and it still is a work in progress!

In the couple of years prior to this episode, I had already started taking more physical exercise, and in particular doing more walking, hiking and trekking. This was also a key part of my recovery, Beyond being just something which was good for my physical health, it was also important for me as part of my sense of self, my identity, to feel that there was something in my life which I thoroughly enjoyed and was dedicating time to which didn't involve work. For the rest, as it had happened before, and will happen some more in later years, serendipity had a part to play.. While I had plans for a new role in the same organisation, I got contacted for a role with another company, at walking distance from my house (compared with the 130 miles return trip my usual place of work required). It wasn't a step up, barely a step sideways professionally, but still role accountabilities I was really interested in, in a new type of environment for me. And this was probably the first time I made a decision which wasn't motivated by moving up in status, or in pay, realising that this never-ending upwards trajectory was one which might have been expected of me, considered as the only manifestation of success, when in fact it wasn't my own ambition and measure of personal fulfilment. This move enabled me to put in place healthier habits, to start being more intentional about wellbeing. It also marked the start of my experience within the defence industry, which brought with it an altogether different challenge from a moral perspective, which I will cover in the next episode of this series.

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