Long Term Care (LTC) in Canada

In this position paper, we review the known root causes of this disaster, including: governance, structural relationships within the broad health care system, funding (public and private), and human resources, all necessary but not sufficient to repair the deficiencies. We will emphasize what we believe are the most challenging but fundamental requirements for change: leadership and culture.

The Real Causes of Work Burnout
Dec 7, 2017

The primary cause of work-related burnout is overload. And don’t fool yourself; you’re not “staying ahead of the game” by answering e-mails and text messages at all hours of the night, while multi-tasking in the washroom on your iPhone or BB or at your child’s hockey game or getting up in the middle of the night when like a Pavlovian reaction, you respond to the buzz, the beep, the ping, the tone of your PDA, tablet or laptop. You are simply overloading your system. And, what is “the game” that we’re trying to stay ahead of anyway?

Here’s a thought for consideration. Most overload is self-induced. The organization system will keep creating expectations as long as you are willing to acquiesce. So if you combine other-induced plus self-induced overload, you are clearly rendering yourself extraordinarily vulnerable to burnout.

We can joke about it, but frankly, you already know your symptoms of burnout. Many of my clients report being unable to have a decent night’s sleep (any one of difficulty falling asleep, staying asleep or waking up ever earlier in the morning without being able to fall back asleep), reduced sexual interest or drive (how can you perform when your mind is preoccupied), irritability with those closest to you (you let your guard down at home due to self and other induced pressure at work), being accused of not paying attention either at home, work or both (mind is distracted), guilt feelings because you are not attending to those closest to you, psychosomatic symptoms such as diarrhea, loss of appetite, palpitations associated with no specific anxiety-laden stimulus, feeling unable to get going on the weekend, or having the experience of “thank G-d it’s Monday” so you can get back to work, or being unable to get going at the start of the week due to reduced interest and motivation (generally accompanied by dreaming of taking a job on a Caribbean island), or worse yet, using drugs of one form or another to get the buzz or feel the high.

If you think that leading a healthy lifestyle is sufficient to buffer against these symptoms, you better think again. Sure, you will feel better physically and even psychologically (on a transient basis). That said, if you truly want to gain a measure of control of your life and reduce or eliminate the symptoms of burnout described above, here are some actions you can take starting tomorrow…..and you have no further to look then yourself:

  1. self-worth: ask yourself whether your self-worth is a function of your performance, accumulation of worldly possessions or how perfectly you perform; if that’s where your mind is at you will never be able to jump off the treadmill. Instead, ask yourself where your values, beliefs and relationships fit into the self-worth equation; were your parents or significant others right when they said or implied that perfection was attainable and the goal in life, that winning was everything, or that love was conditional on performance— weren’t these more a reflection of their own neuroses.
  2. fall in love or fall in love again: whether with your partner, spouse (not your friend’s spouse…although that too is frequently a symptom of burnout), children, friends….this takes time and focus; you might fool yourself into believing that the emotional connection is always there, but in reality it is quite superficial;
  3. self-management: ironically, those of us who are governed by BBs, iPhones, texting, incessant, after-hour or weekend conference calls, “facebooking”, coupled with ever growing demands from the workplace believe that by working longer and harder they are actually in control; the irony, of course, is that they are under the control of others or their machines. So, learn to say “no” or negotiate the request, or delegate (even though we all realize that others are not as perfect as you), schedule 30 minutes of downtime between appointments, work out at lunch hour, commit to literally not working on Saturday and/or Sunday. Bottom line….re-take control of your life.
  4. insecurity: countless of times, clients have shared with me the fantasy that if they don’t “keep at the switch” they’ll loose their jobs or some fantastic opportunity, or that they will become destitute (let alone not be able to afford the bigger car, house or vacation), that they’ll be characterized as “shirkers” and the like. The paradox, of course, is that staying at the switch is no guarantee of anything; that in reality, what accounts for success is ability and engagement….not pushing oneself to the limit due to some inherent insecurity. So, sit back and assess what truly accounts for your success or for that matter poll those who know you to find out why they see you as successful. You may be surprised to discover that simply showing up is not what truly got you there, but it’s your ability, your relationship effectiveness and your professionalism which did it for you. And, how realistic is it that you’ll ever become destitute?
  5. perfectionism: or what I prefer to refer to as “the disease of perfectionism”. Lexus, although I happen to own one, ought to change their motto from “the relentless pursuit of perfection” to the “relentless pursuit of excellence”. Much more attainable and realistic. Those who aspire to perfection are simply tying self-worth into performance. Hence, the more they perform and the better they perform, the more they believe others will approve of them. Again, consider the paradox. Perfectionists, although they can be quite nice, are at the very least a “pain”; they’re personally never or rarely satisfied with themselves or others, consistently find-fault or blame others, and keep setting increasingly unrealistic standards…..how can they possibly connect this type of behaviour with their actual goal which is to win the approval of others by being perfect. Only when they act in a more tolerant fashion of their own human foibles, and those of others, will they take the heat off themselves and others. Only then will they endear themselves to those they care about—and the approval they so desire. Sure, they will receive positive reinforcement from some for their exceedingly high standards; yet the irony is that these people will now expect this level of performance each and every time. The stress level associated with perfectionistic tendencies, both in one self and what perfectionists cause others, is extraordinary.
  6. anger: internalized anger, resentment, contention or conflict eat away at one’s physical and psychological well-being. Burnout is clearly one of the symptoms. The only alternatives are to recognize when and how anger, etc. are self-induced due to unrealistic expectations or misguided belief systems (read Albert Ellis for a more detailed account), and, if the negative emotion is justified or warranted that one learns to express these feelings in a modulated and respectful way. Being assertive is key; it’s the alternative to being passive and internalizing anger, or expressing anger with such velocity that it destroys the recipient and the perpetrator both.

I recognize that these are attitudes and behaviours which may have become habitual over the years and, for some, may be extraordinarily difficult to change. Yet, without addressing these, most other self-help strategies will miss the mark or produce transient benefits at best. Indeed, if these fundamental underpinnings are left unaddressed, I have observed people applying the same attitudes and behaviours to strategies designed to produce relief; for example, approaching exercise as a religion and with the same vigor that got them into trouble in the first place.

Addressing these behaviours and attitudes are essential to ameliorating burnout and truly regaining control over one’s life. Not to say that exercise and other lifestyle management techniques are not beneficial; they are. But they don’t address root cause issues which render the individual to be at the mercy of external forces, rather then developing what has been called “an internal locus of control”.

Gerald (Gerry) Pulvermacher earned a doctoral degree in Clinical Psychology in 1973. Earlier in his professional career, Gerry focused on working with people who manifested anxiety and stress-based problems in living (such as burnout). Since 1979, Gerry has focused exclusively on working in organizational systems helping senior executives transform their businesses to meet both internal and external demands or opportunities, align their organization and people with their business strategy and enhance their leadership effectiveness, both as individuals and executive teams. 

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