Burn-out affects nearly one million Dutch employees, yet clinical diagnoses of burn-out remain pr... more Burn-out affects nearly one million Dutch employees, yet clinical diagnoses of burn-out remain problematic. Diagnostic uncertainty exists due to a lack of positive neurobiological markers and specific biomedical mechanisms, hence burn-out is solely verifiable based on patients’ own descriptions. Research into similar conditions suggests such diagnostic uncertainties often undermine the perceived ‘realness’ and legitimacy of the condition and its treatment. In contrast, burn-out seems to be considered a ’genuine’ medical condition in the Netherlands, granting access to financial compensation, psychotherapeutic treatment, rehabilitation and two years paid work-leave. To examine this interesting phenomenon, the study reported here explores perceptions and understandings of burn-out – particularly how these wider ideas and perceptions associated with the condition, impact those suffering from burn-out. Eighteen patients were involved in the research which was carried out via in-depth narrative interviews, alongside interviews with five physicians and seven occupational health specialists. The interviews showed that burn-out patients were often associated with characteristics such as being loyal, dutiful, dedicated and hard working. Some were even described as 'the perfect employee’, or as one physician described: ‘the tired hero, always worked hard and gave his all’. As another physician explained ‘[Burn-out] implies that you really worked hard, so burn-out is actually quite cool.’ Such discourses may be understood in light of wider Dutch norms, historically rooted in Protestantism, by which hard work is a laudable virtue. Another participant explained how this may affect attitudes towards patients: ‘If someone who really busts a gut gets burned-out, people have respect for it.’ Hence, these hard-working individuals may become regarded with a degree of admiration, leading to a positive self-image: ‘Softies do not burn-out. You need to work very hard to get burned-out.’ These perceptions and ideas associated with burn-out help us understand why the condition is viewed as relatively legitimate, in contrast to other conditions such as chronic fatigue syndrome – where similar diagnostic uncertainties exist but where patients regularly experience much less recognition and acceptance.
Burnout is an illness label, and in some healthcare systems a diagnostic category, which has rece... more Burnout is an illness label, and in some healthcare systems a diagnostic category, which has received growing attention and usage. Despite its ubiquity and widespread media coverage, the medical sociological literature on the condition remains small and the wider sociological literature tends to treat the rise of burnout as a straightforward reflection of changing working environments. Very few studies have critically reflected on the nature of burnout, its diagnosis and lived experiences of the condition. This neglect is surprising given the relative legitimacy of burnout as an illness category in several national healthcare contexts, not least in the Netherlands. Drawing on in-depth qualitative interviews with a range of burnout sufferers (n = 18) and diag- nosing professionals (n = 12) in the Netherlands, we explore participants’ narrated understandings of the con- dition in light of a reworked Parsonian framework. Narratives suggested sufferers of burnout generally received legitimation, often being understood as hardworking, diligent and altruistic. Experiences of (partial) acceptance through a medical label, and the relative lack of stigma were important to sense-making and coping. This recognition of burnout was particularly striking, given several features burnout shares with conditions commonly associated with ontological doubt, moral suspicion and stigma. Yet recognition of commitment and strength sat in tension with psychological assistance, which sought to correct tendencies for working too hard for too long. Drawing on insights from Habermas’s extensive reformulation of Parsons’s work, we understand the legitimation and tensions around burnout care in light of meanings, metaphors and manipulation which, in turn, we locate in relation to the functioning of wider socio-cultural lifeworlds and political-economic systems, including the sediments of earlier political-economic and cultural structures.
Sociological theories of health risks in late modernity emphasise the individualisation and incre... more Sociological theories of health risks in late modernity emphasise the individualisation and increasing anxiety that results from prevention policies, while bio-sociality theories point to the creation of new, biologically or medically based social identities. In this article, we outline an alternative approach. We use micro-sociological interaction ritual theory to examine how health risk prevention technology shape interactions that generate collective identities. Drawing on fieldwork in two Dutch villages in 2008–2009 and again in 2014 that created interview, survey and observational data, we show that automatic external defibrillators turned into symbols of collective identity that elicited feelings of group membership, reflected moral values and filled community members with pride. We demonstrate that this collective identity formation process was shaped by the institutional and technological network of the automatic external defibrillators. In the concluding section of the article, we explore the conditions under which health-related collective identities might develop, particularly with regard to the institutions that create health policies and foster health risk awareness.
Burn-out affects nearly one million Dutch employees, yet clinical diagnoses of burn-out remain pr... more Burn-out affects nearly one million Dutch employees, yet clinical diagnoses of burn-out remain problematic. Diagnostic uncertainty exists due to a lack of positive neurobiological markers and specific biomedical mechanisms, hence burn-out is solely verifiable based on patients’ own descriptions. Research into similar conditions suggests such diagnostic uncertainties often undermine the perceived ‘realness’ and legitimacy of the condition and its treatment. In contrast, burn-out seems to be considered a ’genuine’ medical condition in the Netherlands, granting access to financial compensation, psychotherapeutic treatment, rehabilitation and two years paid work-leave. To examine this interesting phenomenon, the study reported here explores perceptions and understandings of burn-out – particularly how these wider ideas and perceptions associated with the condition, impact those suffering from burn-out. Eighteen patients were involved in the research which was carried out via in-depth narrative interviews, alongside interviews with five physicians and seven occupational health specialists. The interviews showed that burn-out patients were often associated with characteristics such as being loyal, dutiful, dedicated and hard working. Some were even described as 'the perfect employee’, or as one physician described: ‘the tired hero, always worked hard and gave his all’. As another physician explained ‘[Burn-out] implies that you really worked hard, so burn-out is actually quite cool.’ Such discourses may be understood in light of wider Dutch norms, historically rooted in Protestantism, by which hard work is a laudable virtue. Another participant explained how this may affect attitudes towards patients: ‘If someone who really busts a gut gets burned-out, people have respect for it.’ Hence, these hard-working individuals may become regarded with a degree of admiration, leading to a positive self-image: ‘Softies do not burn-out. You need to work very hard to get burned-out.’ These perceptions and ideas associated with burn-out help us understand why the condition is viewed as relatively legitimate, in contrast to other conditions such as chronic fatigue syndrome – where similar diagnostic uncertainties exist but where patients regularly experience much less recognition and acceptance.
Burnout is an illness label, and in some healthcare systems a diagnostic category, which has rece... more Burnout is an illness label, and in some healthcare systems a diagnostic category, which has received growing attention and usage. Despite its ubiquity and widespread media coverage, the medical sociological literature on the condition remains small and the wider sociological literature tends to treat the rise of burnout as a straightforward reflection of changing working environments. Very few studies have critically reflected on the nature of burnout, its diagnosis and lived experiences of the condition. This neglect is surprising given the relative legitimacy of burnout as an illness category in several national healthcare contexts, not least in the Netherlands. Drawing on in-depth qualitative interviews with a range of burnout sufferers (n = 18) and diag- nosing professionals (n = 12) in the Netherlands, we explore participants’ narrated understandings of the con- dition in light of a reworked Parsonian framework. Narratives suggested sufferers of burnout generally received legitimation, often being understood as hardworking, diligent and altruistic. Experiences of (partial) acceptance through a medical label, and the relative lack of stigma were important to sense-making and coping. This recognition of burnout was particularly striking, given several features burnout shares with conditions commonly associated with ontological doubt, moral suspicion and stigma. Yet recognition of commitment and strength sat in tension with psychological assistance, which sought to correct tendencies for working too hard for too long. Drawing on insights from Habermas’s extensive reformulation of Parsons’s work, we understand the legitimation and tensions around burnout care in light of meanings, metaphors and manipulation which, in turn, we locate in relation to the functioning of wider socio-cultural lifeworlds and political-economic systems, including the sediments of earlier political-economic and cultural structures.
Sociological theories of health risks in late modernity emphasise the individualisation and incre... more Sociological theories of health risks in late modernity emphasise the individualisation and increasing anxiety that results from prevention policies, while bio-sociality theories point to the creation of new, biologically or medically based social identities. In this article, we outline an alternative approach. We use micro-sociological interaction ritual theory to examine how health risk prevention technology shape interactions that generate collective identities. Drawing on fieldwork in two Dutch villages in 2008–2009 and again in 2014 that created interview, survey and observational data, we show that automatic external defibrillators turned into symbols of collective identity that elicited feelings of group membership, reflected moral values and filled community members with pride. We demonstrate that this collective identity formation process was shaped by the institutional and technological network of the automatic external defibrillators. In the concluding section of the article, we explore the conditions under which health-related collective identities might develop, particularly with regard to the institutions that create health policies and foster health risk awareness.
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Papers by Jolanda Boersma