PSYCHOTHERAPY: THEORY, RESEARCH AND PRACTICE

VOLUME 12, # 1 , SPRING, 1975

THE STAFF BURN-OUT SYNDROME IN ALTERNATIVE INSTITUTIONS
HERBERT J. FREUDENBERGER*
890 ParkAve., New York, N.Y. 10021
Some years ago, a few of us who had been
working intensively in the free clinic movement
began to talk of a concept which we referred to as
"burn-out." Having experienced this feeling
state of burn-out myself, I began to ask myself a
number of questions about it. First of all, what is
burn-out? What are its signs? What types of
personality are more prone than others to its
onslaught? Why is it such a common phenome-
non among free clinic folk, or is it also some-
thing that strikes all or at least most staff mem-
bers working in alternative self-help or crisis
intervention institutions? Does it happen with
the same intensity to the professional volunteer
and to the volunteer service worker? Or does it
affect the volunteer and paid staff member dif-
ferently? What can we do about burn-out once it
starts? And what criteria can we build within
ourselves or our working environment to help us
to safeguard against this serious occupational
hazard?
WHAT IS BURN-OUT?
The dictionary defines the verb "burn-out" as
' 'to fail, wear out, or become exhausted by mak-
ing excessive demands on energy, strength, or
resources." And that is exactly what happens
when a staff member in an alternative institution
"burns out" for whatever reasons, and becomes
inoperative for all intents and purposes.
Obviously, burn-out is not an exclusive
phenomenon in self-help groups. It is present
also in the addict who shoots up until he burns
out and possibly dies; it is present in the speed
freak when he reaches his maniacal speed runs
and lives merely for the shooting up; it is present
in the compulsive gambler, the golf freak, the
* Mental Health Coordinator to S.E.R.A. (a Latino
therapeutic community) and staff training consultant to state
and federal agencies.
overweight person, to name just a few. It cer-
tainly is present in industry and business. We all
know the story of the ulcerated executive and
what he has done to himself. What is different,
however, for us in the alternative institutions is
that we usually are fighting a battle on at least
three frontswe are contending with the ills of
society, with the needs of the individuals who
come to us for assistance, and with our own
personality needs.
The burn-out manifests itself in many differ-
ent symptomatic ways which vary in symptom
and degree from person to person. It usually
occurs about one year after someone has begun
working in an institution, because it is just about
at that point that a number of factors begin to
come into play.
One of the chief preludes to burn-out seems to
be loss of charisma. The leader, for example, has
begun to doubt his own powers to heal and to
lead his staff. His staff also now takes him for
granted, or has become disappointed in him be-
cause the "miracles" they expected him to per-
form for them and that he expected of himself as
well have not materialized. Neither have the
extent of changes that the staff hoped would be
provided by the existence of the self-help or
crisis unit. Even though in the beginning the
leader did manage to do what no one else had
been able to donamely, get the institution off
the ground and keep it goingthe charisma has
dwindled, along with the initial "high" experi-
enced by him and the others, and the amazement
that was felt at first success. It is at this point that
not only the leader but every member of the staff
must take a good look at why he or she started
working in the institution in the first place, what
were the motivations, and what kind of trip one
may be ona self-fulfilling ego trip, a self-
aggrandizement ego trip, a self-sacrificing,
dedication-to-others ego trip, or a trip to help to
deny one's own serious personal problems.
73
74 HERBERT J. FREUDENBERGER
Once we come up with an honest answer to
these questions, we will have a better opportun-
ity to cope with a potential burn-out.
But let us suppose that one has not been ques-
tioning oneself, and that a burn-out is slowly
occurring within. What are the signs that begin
to manifest themselves in burn-out? For one,
there is a feeling of exhaustion and fatigue; be-
ing unable to shake a cold, feeling physically run
down; suffering from frequent headaches and
gastro-intestinal disturbances; this may be ac-
companied by a loss of weight, sleeplessness,
depression, and shortness of breath. In short,
one becomes psychosomatically involved in one
or more ailments. These are some of the physical
signs of burn-out. I will get into behavioral and
psychological signs later in this article. Another
question to raise is, what are the different types
of personality most prone to burn out in alterna-
tive self-help or crisis intervention settings?
THE DEDICATED AND COMMITTED WORKER BURN-OUT
Those of us who work in free clinics,
therapeutic communities, hot lines, crisis inter-
vention centers, methadone clinics, gay or draft
counseling centers, women's consciousness
raising groups, runaway houses, and any of the
other self-help groups that are community based,
are people who are seeking to respond to the
recognized needs of people in a particular com-
munity. It does not matter to us whether the
people we are seeking to help are black, his-
panic, white, young or old. The need is there,
and we respond. Those of us who work to help
those in the community are there because we see
ourselves as dedicated people in some ways, and
as enlightened people in other ways. We see
ourselves as enlightened either socially, or polit-
ically, spiritually, or intellectually. Some of us
are there to gain enlightenmentwe are looking
for some further personal identity or for a shift of
our own life style. Nevertheless, we are there,
first of all, to be of help, but also because we are
struggling with our personal value systems, try-
ing to formulate and develop different and in-
novative treatment approaches or communal liv-
ing styles. But whatever it is we are seeking to
do, we believe ourselves to be dedicated through
our work involvement. We would literally rather
put up than shut up. And what we put up is long
working hours in the community, with a bare
minimum of financial compensation, but hope-
fully with much personal gratification in its
place.
It is precisely because we view ourselves as
dedicated and committed people, that we are
likelyif we do not watch outto subtly get
ourselves into a personal burn-out trap. The
committed worker tends to take on too much, for
too long, and too intensely. He must learn to
recognize that in the very commitment he feels,
there rest pressures from a number of sides. First
of all, he feels from within himself the pressure
to accomplish and to succeed. Secondly, he feels
from without himself the pressure of the needs of
the population he is trying to servethe desper-
ate needs of the runaway, of the kid on a hot line
call, of the frightened and sick and lonely young
boy or girl, or old man or woman coming into a
free clinic for health care, of the urgency of the
addict seeking to shake his addiction. The emo-
tional demands of all these needs upon us is
tremendous. If these pressures are compounded
by othersfor instance, by an administrator
who forces the already over-committed worker
to play a statistics and numbers game with him
because he wants ' 'to look good in the communi-
ty' s eyes, " and because, alas, he too is
dedicatedthen the committed worker had bet-
ter watch out. He is in a three-way squeeze and
will come down with a three-level burn-out. He
will be at the mercy of his own needs, the needs
of the population seeking help, and the adminis-
trator's needs.
It is at this point, that the dedicated worker's
guilt, his feelings that he is a super-being helper,
his desire for being of genuine help, pushes him
ever onward to work even harder, because such a
person believes that the only way to stem the
flood of demands upon him is to put in more
hours and more effort. What happens is that the
harder he works, the more frustrated he be-
comes; and the more frustrated he is, the more
exhausted, the more bitchy, the more cynical in
outlook and behaviorand, of course, the less
effective in the very things he so wishes to ac-
complish.
Let us remember that there are differences
between commitment, over-commitment, in-
volvement, and dedication. For me, over-
commitment implies a total emotional or intel-
lectual bondage to a certain idea or course of
action. Whereas involvement implies mature
concern and sympathy, interest in or even ab-
sorption by someone or something. Mature ded-
THE STAFF BURN-OUT SYNDROME
75
ication implies devotion and consecration of
oneself to a particular activity, pursuit, cause, or
person. It is the overly dedicated and the exces-
sively committed individual who will suffer. In
order for us to be of help to others, we must feel
concern, we must have a life of our own, and
retain parts of our emotional life which remain
entirely our own. Finally, we must be aware of
our realities and limitations as human beings. If
we are not all of these things, we are headed for a
sure burn-out.
Another point to reflect upon is this: the popu-
lation which we help is often in extreme need,
and because of this they continually take, suck,
demand. Let us be honest about it, and admit that
the people I am referring to require a continuous
giving on our part. And our feeding supplies
appear, both to us and to them, to be endless. We
soon learn, however, that this is a mistaken no-
tion. The supply canand often very quickly
doesdry up. When we are empty, where do we
replenish from? Too often, because of the nature
of our work with the people who come to us, the
single calls, one-visit therapies, we receive very
little or no feedback. On top of this, if the rest of
the staff is as busy as we are in running around,
and slowly burning out themselves, we are cer-
tainly not going to receive good feelings or feed-
ings from them. And so, another poor cycle is in
the making.
There are other conditions of our work that
can lead to burn-out. No matter how initially
exciting our work may be, in time the boredom
of the task and the monotony of the problems,
complaints, the hassles for funds, the battles
with the straight agencies, the police, or the local
populationand our responses to thesecan
get the better of us. It is, therefore, critically
important to the prevention of burn-out that there
be a continued awareness of the built-in potential
of boredom, frustration, and diminishing turn-
on in the work. One way of circumventing these
debilitating reactions is to have the staff periodi-
cally shift into different tasks. A clinician, for
example, might get into lecturing in the com-
munity. The one who puts out the clinic's news-
paper may go into training as a clinician or a
hot-liner. A great attempt should be made, in
other words, to make the job functions vary, in
order to prevent the loss of a valuable person in
terms of the skills he or she has gained while
working with you. Too often I have seen a valu-
able person leave in disgust and disenchantment
because he has burned out. This is as much the
fault of the institution as it is that of the indi-
vidual. We ought to always remember that the
human being is more important than the task. If
the task of the burning out staff member is that of
turning out a newspaper, and he or she is the only
one who can, then it is better to have no paper at
all, than to have that staff member burn out even
more just to keep the paper going.
Another facet which is built into the work of
an alternative staff person is the necessity of our
being constantly open and in touch with other
people's needs and wants. Our own needs and
wants are usually secondary. Theirs are primary.
Furthermore, this openness to others is de-
manded of us on a constant, day-in and day-out,
all-hours-of-the-day-or-night basis!
To be open to this degree is a requisite for the
staff of a therapeutic community. For example,
they must be ready to give haircuts (verbal rep-
rimands), probes, to call encounters, to have
encounters called on them, to rap, to receive
criticism, to be sympathetic, to be firm, to have
patience, to ignore their own discomforts and
preferences almost without respite. Obviously,
when we talk to others of what we do, many
object and say, "Well, that's an impossible way
to function. You can't keep that sort of thing
up. " But the truth is that we do keep it up and are
expected to do so. The plain fact is that the staff
is expected to be much more open to people,
more alert and emotionally responsive than may
be advisable if looked at realistically. This is
especially so when we compare what is required
of the staff in therapeutic communities, with
what is expected, say, in business, industry,
politics, or in straight social agencies, univer-
sities, or hospitals. In those settings we are not
asked to put our feelings "up front" and on the
line every minute of our working time.
We should recognize that for some staff the act
of suddenly leaving or splitting from a clinic is
almost a desperate, last ditch effort at survival.
Why is it that so few alternative institutions give
people who leave good send-offs? There is in this
almost an implied feeling that the splittee has
done wrong in leaving. Why is it that we do not
acknowledge all the good work that he or she
may have done while there? Why do we not
recognize that to work on the outside as a regular
establishment clinician requires that one always
be there, that one do research, work on statistics,
be an administrator, serve in one of the clerical
76 HERBERT J. FREUDENBERGER
sections, or be out in the community, and that
such a clinician's job has a built-in slack time-off
period. But for the alternative institution clini-
cian, this is seldom possible or expected. We
absolutely must recognize this reality for all the
clinicians who work in self-help groups.
Whether a clinician is a counselor, nurse, physi-
cian, psychologist, dentist, or what have you
the drain is the same.
A further point to consider is that the continual
demand for openness leaves the worker quite
exposed. I have observed on many occasions
workers leaving a marathon or encounter after a
few hours. They just couldn't take it any longer.
The emotional strain was just too much for them.
This leaving, this running off to Florida, Puerto
Rico, the Caribbean, an island off Mas-
sachusetts, or just a nearby beach, is a direct
consequence of burn-out after the horrendous
and time-consuming, energy-draining experi-
ences they have been through. In leaving, they
talk of not being appreciated enough, of not
receiving enough encouragement or praise. Be-
fore they leave, they have a way of going around
seeking positive "strokes" (the word used for
approval or complimentspats on the head).
Many feel that while working with the group so
many personal feelings "got kicked off" or that
so much repressed material has become more
conscious that they must do something to handle
them. Too often they feel that they have had "to
stuff" these feelings and materials (in other
words, to hold them in) rather than expressing
them freely. If enough repression has occurred
and not enough open sharing and approval
gained, then the outcome is often a quiet depres-
sion, forlorness, or feelings of alone ness and
lonelinessand ultimate burn-out leaving.
Furthermore, if the administrator, the direc-
tors, or co-ordinators are not alert to this need
and dismiss a worker's open or covert begging
for "strokes" as mere self-indulgence or child-
ishness, or non-productive behavior, a burn-out
syndrome can be started.
THE STAFF MEMBER WHO IS OVER-COMMITTED AND
WHOSE OUTSIDE LIFE IS SUB-SATISFACTORY
Another candidate for burn-out is the
personality-type who uses the clinic as a substi-
tute for a social life. It is so easy to become
excessively involved in a free clinic, hot-line, or
crisis-intervention unit. The atmosphere and the
satisfactions can be so seductive that you find
yourself spending even your free time there. But
I view this over-involvement as a real danger
sign indicating that the worker has given up
trying to find meaningful outside activities and
relationships. Thus, most, if not all, of the work-
er's gratifications will come from the institution.
This individual will then give more of his or her
time to the institution and work harder than any-
one else. He will become so enmeshed in the
organization and its petty or not so petty quarrels
that he will have little time left for himself and
will soon lose himself. This kind of merging
with the institution leads to an "attack me, attack
my institution" attitude and to a loss of self.
As human beings we must have an outside life
that is separate and distinct from our work life.
We must have some space of our own, especially
if we live and work communally. Many self-help
groups encourage their members to live in the
geographic area of the institution, often right in
the institution or commune. They encourage this
closeness in an attempt to promote the atmos-
phere and feeling of "family." They try to en-
gender the ' 'belonging'' feeling that comes with
doing everything together. We, they are saying,
are the people we are seeking to help. But, in
encouraging this physical closeness and
exclusivity of interest and contact, we too often
ignore the realities of private time, private living
space, private reflections, private activities, pri-
vate creativeness, and the constructive, re-
juvenating, "feeding" aspects of privacy and of
being allowed to be alone when we find it neces-
sary to our sense of well-being.
THE AUTHORITARIAN BURN-OUT
The next personality prone to burn-out is the
authoritarian, the type of individual who so
needs to be in control that no one else can do any
job as well as he can. Not only does this type tend
to start a personality cult, but his having to do
everything himself prevents others on the staff
from receiving adequate training themselves.
The authoritarian has another negative effect
upon the institutionhis "only I can do things
right around here" attitude leads to cynicism,
and bad rapping among the other members of the
community. I personally had the unfortunate ex-
perience of working with such an administrator
in a free clinic. He could not let go of anything.
His need for control of the budget, the funds, the
THE STAFF BURN-OUT SYNDROME
77
work, the doling out of methadone, the intrusion
into all of our work, ultimately lead to mass staff
resignations, as well as to his sudden running
and leaving. He had overextended out of a deep
personality need to control, and burned up in the
process.
THE BURN-OUT OF THE ADMINISTRATOR
A special kind of burn-out, which is different
from the usual staff burn-out, is the case of the
administrator who, aside from any particular
personality problems of his or her own, is
genuinely overworked.
When the administrator first starts to work in
an alternative institution (he may be the co-
ordinator, the director, the leader, the head, or
whatever title you want to give him), he works
his tail off. He is usually the force that holds
things together and keeps the machinery run-
ning. But in time, if safeguards are not built into
his role, the director begins to believe that he is
indispensable. Just as the authoritarian staff
member does, the director isolates himself from
the others. By this isolation, they prevent others
from building any sort of expertise for them-
selves. For example, the director becomes the
only one who can write a proposal, address the
board, meet a reporter, confer with the mayor,
handle staff training, approach the foundations
for money and hold meetings with them.
The overworked administrator suffers still
another source of burn out. Not only does over-
work lead to physical fatigue, it also leads to
boredom. For one thing, being asked to attend
too many meetings, whether inside the institu-
tion or outside, to repeat his fund-raising argu-
ments before too many foundations, to train too
many staff membersall this has a routinizing
effect on him. The meetings and faces tend to
fade one into the other. A solution? Try having
others attend meetings once in a while or on an
alternating basis. Give away some job functions
to other staff members. Not only will you, as the
director, benefit from thiseveryone else will
too.
Another very real cause of an administrator's
burn-out is his having constantly to be wearing
one of two hats. There's the "freak" hat he
wears within the self-help community, and
there's the straight hat he wears when he is
meeting people outside the institution, such as
the police, the city council, the Kiwanis or other
funding representatives.
Having to wear two hats puts the adminis-
trator's own psychic well being in jeopardy. This
constant flitting back and forth, turning on and
off like a TV switch, can be exceedingly drain-
ing and disorienting. Switching may involve al-
most his whole person, and have to be carried to
ridiculous proportions. He may have to change
his attire, his appearance, his speech pattern, his
mannerisms, and even his thinking patterns. For
instance, to use the word "fuck" in a training
session is fineexpected. But to utter such a
word during a TV interview is not cool, to say
the least. In order to guard himself against such a
blunderif such words are part of his usual,
easy manner of speakingrequires a tremen-
dous effort and concentration. Having to switch
back and forth several times during the course of
a week can accelerate his exhaustion rate. It
leaves him wide open to burn-out.
It becomes, therefore, very important for the
administrator to learn how to delegate functions.
He must be sure that he doesn't allow himself to
become a detriment to the institution. He must
learn to share his griefs, his disappointments, his
hangups, and his frustrations with the people he
works with on his staff.
He must, let us face it, come to grips with the
fact that he cannot be the whole show. He must
relinquish his pre-eminent position and admit
that his most productive role may be that of an
interface person, one who is needed to act as a
bridge between the outside (straight) community
and the inside (freak) world.
THE BURN-OUT OF THE PROFESSIONAL
An especially difficult series of problems con-
fronts the professional who decides to lend his
services to an alternative institution. As I wrote
elsewhere (1971, 1973), the professional
whether he or she be a psychologist, a physician,
a nurse, a social worker, a dentist, an account-
ant, a lawyer, or an educatorneeds to be aware
of his tendency to over-identify with those he is
working with and for, and that in the process he
runs the risk of losing himself.
As professionals, we also need to convey to
others our feelings of wanting to be needed
above and beyond the skills for which we were
trained and which we are qualified to perform.
The physician, for example, must, therefore, be
helped to break down his imposed self-image
78 HERBERT J. FREUDENBERGER
role, one that states that his responsibility is
solely to tend to the body. If a physician con-
tinues to practice in his off hours the same func-
tions that he practices in his everyday hours
even though he has volunteered to do sohe will
soon experience the feeling that he is once again
being routinized, or he may even experience a
feeling that he is being ripped offin other
words, used.
We must, therefore, be very sure to remember
that the professional working in the alternative
institution is vulnerable. We must remember
that he is often working for no pay and that he is
there for reasons of personal gratification. If he is
forced, then, to perform the very same duties at
night that he performs during his ordinary
work-day hours, he will eventually feel abused
and disenchanted. It is obvious that the profes-
sional who wants to give his skills free or for a
small remuneration to a self-help group must be
made to feel that he is able to be of service in both
his own professional functions and in others for
which he is allowed to prove he is also qualified.
I remember in one instance where a physician
wondered why he was never asked to help write a
proposal for funds. He asked me whether I
thought that he could not be of any help. This
man wanted very much to be seen, not just as a
physician, but also as an involved human being
working with others to bring about change in our
society.
A further very real factor contributing to
burn-out for the professional is the number of
hours he or she devotes to his profession during
the day and again at night. His volunteer work
literally means that he is holding down two jobs,
and most likely giving more than full measure to
both. I know for a fact that one of the reasons I
burned out the first time was that I worked a
complete day (perhaps ten or twelve hours) in
my independent practice as a psychoanalyst, and
then left my office to work in the free clinic until
midnight or later, only to return to my office the
next morning at eight. Exhaustion or collapse
was sure to follow. I found that it just was not
easy to leave the clinic at night. There was just
too much to do. On the one hand when we started
the free clinic in New York City, we first had to
become aware of the needs and problems of the
many young people coming in (Freudenberger,
1971). Then it was necessary for me to train the
many high school and college people in the
techniques of crisis intervention, counseling,
and on the third hand, I had a very real problem
with an immature administrator. Trying to bal-
ance all these forces, and attempting to build a
cohesive clinic staff just became too much for
me. After about one and a half years, I found
myself in a state of physical exhaustion, too tired
to go on vacation with my family, easily irri-
tated, found it difficult to sleep and just had to
leave the free clinic entirely in order get myself
together again. I took off one month, spent time
thinking and writing about my feelings, some of
which I published (Freudenberger 1968, 1972),
and the rest I kept for future thinking. I found
that it was difficult for me to share my feelings
with other professionals since at the early stages
of 1968, so few had been working in alternative
institutions, and really did not understand what I
was undergoing. Their advice of "leave the
place, it gets you so upset," was not sufficient
for me. I had invested too much, needed to
leave, but also needed to understand and mourn a
deeply felt loss.
THE SIGNS OF BURN-OUT
As I indicated earlier, there are the physical
signs of burn-out. There are also the behavioral
and psychological signs of burn-out. For exam-
ple, the person who used to be a talker, now
remains silent. We notice that he used to con-
tribute to staff meetings, but now he sits in a
corner and says nothing. Why? He may have
become resigned to a hopeless situation. He is
fatigued, bored, resentful, disenchanted, dis-
couraged, confused. He feels futile and fed up,
and cannot talk about it.
Other behavioral signs of burn out we should
consider are, for example, the quickness to anger
and instantaneous irritation and frustration re-
sponses. The burn-out candidate finds it just too
difficult to hold in feelings. He or she either is, or
feels, so overburdened, that the slightest occur-
rence can set him off . . . a word, a felt slight, a
small disappointment, not to mention an outright
tirade, criticism, or abuse.
With the anger such an individual feels, there
may also be a suspicious attitude, a paranoia that
evolves. The burn-out victim begins to feel that
just about everyone is out to screw himand this
can include his own brothers and sisters on the
staff.
The paranoid-like state may also be
heightened by feelings of omnipotence. The vie-
THE STAFF BURN-OUT SYNDROME 79
tim now feels that he or she knows it all, has been
through it all, has experienced every kind of rap,
every kind of con man or woman around, has
handled it all before.
With these feelings of omnipotence, another
real danger manifests itselfrisk-taking. The
burn-out person will begin to take risks too read-
ily. He begins, for example, to place himself in
counseling situations that might be much too
dangerous for one person to handle alone. He
begins to think he can handle a speed freak, for
example, all by himself in an apartment away
from the clinic. Or, as happened in one instance,
go out, late at night, to an abandoned parking lot
to meet with an addict he hardly knew, who had
called and dared him to come out and get him in
for help. This sort of almost flip attitude towards
the seriousness of counseling and helping
people, and the real risks and danger involved in
some of the work being done by a burnt-out man,
places everyone's safety in jeopardy. At points, I
have noticed that the risk-taking behavior may
even sometimes border on the lunatic. It has
often appeared to me that the "crazy" behavior
of the burnt out person has something in it of a
necessity. He seems to need to do something that
is out of his routine, even if what he does borders
on the crazyit is at least different.
With those individuals who are prone to
psychosomatic symptoms, an excessive use of
tranquilizers and barbiturates may come about.
These are taken under all sorts of guises and
excusesto get rid of a cold that lingers too
long, or so as to be able to sleep better, or to relax
and become less up-tight. Unfortunately, the
symptoms and their "cures" are delusionary.
The person is burnt out and requires some time
off. An irony that I have observed is that the burn
out person who is working among drug addicts,
begins himself to become something of a con
man as he "requisitions" the pills from the in-
stitution's pharmacy and doctors.
SOME PERSONALITY AND BEHAVIORAL SYMPTOMS OF
BURN-OUT
One of the more serious personality manifes-
tations that emerge with burn-out is rigidity. The
person becomes "closed" to any input. His
thinking becomes inflexible. This rigidity is in-
dicated not only in the risk-taking behavior that I
have described, but he is also stubborn and re-
sistant to any change, digs his heels in whenever
new plans and concepts are introduced. Change
is threatening to an exhausted person. The least
little demand upon him that involves a change in
his way of doing thingseven constructive
shiftsbecomes inconceivable to him. He will
fight the change and block it every inch of the
way. Naturally if it is the administrator who is
burnt out or a senior staff volunteer, then the
rigidity resulting from unrecognized overwork
can be very destructive to the entire group and to
more creative progress.
One solution may be to have some other re-
spected member of the staff sit down with the
individual and try to help him see what is hap-
pening. Show him that a point has been reached
where he must take some time off. Occasionally
this works; more often it does not.
One thing that should not be suggested to the
one who has burnt out is that he get his head
together by entering an encounter group, or to
call a staff encounter on him, or even worse to
send him off on a weekend marathon. The
burnt-out individual is in bad enough shape. So
that when he refuses to go into an encounter
group he is merely saving his own life. He may
be instinctively aware that his personal survival
would be threatened in an encounter group. The
encounter group experience is tremendously
draining on the emotions, and would be espe-
cially so to one who has burnt out. What he needs
at this point is understanding, comfort, support
and building upand love. What he definitely
does not need is to be torn down. I remember that
at one point (Freudenberger, 1973), some of the
counselors were faced with having more de-
mands made of them during this horrendous ex-
perience than they could rationally handle. Their
response after the marathon was to run away or
resign.
Another personality indicator of burn-out is a
totally negative attitude. The burn-out becomes
the therapeutic community's "house cynic."
Anything suggested or attempted by others is
bad-rapped. In their negativism the burn-out
seems to be expressing his own depressed state
of mind. "What good would this or that do?"
"Who gives a damn anyway?" "Nobody ap-
preciates what you do for them, so why do it?"
"Why bother? Forget it." "It won't work, I
should know, I've tried it."
A sign that is difficult to spot until a closer
look is taken is the amount of time a person is
now spending in the institution. A great number
80 HERBERT J. FREUDENBERGER
of physical time is spent there, but it is not
quality time. The burnt-out staff member really
just hangs around. He works harder and harder,
and longer and longer, and does less and less. He
wanders aimlessly around in the facility. He
does not seem to know what to do. He does not
like what he has been doing, so he does more of
itless well. He flounders, bungles, makes
wrong decisions. His actions are really saying,
"Hey, someone, look at me and help me, I'm in
trouble," but when you approach him, he denies
that he needs help.
SOME PREVENTIVE MEASURES
Through careful observation and evaluation,
there are some things that can be done to prevent
burn-out. I would like to share some of them
with you.
1. As volunteers come in offering to help,
you can, through a training program, sift people
outor rather help them to sift themselves out.
Some will not last the training cycle and so rule
themselves out for you. It is quite possible that
these people, if they would not have undergone a
training period, would just have entered, worked
more or less well, ultimately left on their own or
burned out rather quickly. Each person who
leaves a self-help setting, especially early in his
work contact, can act as a depressant to the rest
of the staff. So the more you can guard yourself
against a rapid turnover, the better for everyone.
2. Help your training staff to judge and
evaluate the difference between a realistically
dedicated or committed person and an unrealisti-
cally dedicated person. They may be good
people, but you must find out their individual
motivations. Why does this person want to work
in your facility? Is he or she there to help or to run
a trip on the facility? If he is there to help, be
honest with him and point out to him your institu-
tion's philosophy, what the work will take out of
him, and what he can gain from it. In other
words, be straight with the volunteer. It is also a
good idea to try to ascertain what his energy level
is. Ask him questions about his health, his
routine. Does he become ill often? Catch many
colds? Did he ever have mononucleosis?
Hepatitis? Does he need a lot of sleep? Does he
pursue some active hobby? If his energy level is
low, then working in a self-help group may not
be for him, and you may be doing him a favor
when you ask him to reconsider volunteering to
work in an institution such as yours, that is such
an energy drainer.
3. Avoid sending the same staff member into
a given job situation, over and over again. For
example, fund-raising may be a very frustrating
experience. Don't make the same person try to
get funds time and time again. Don't ask one
person to be on the speakers' bureau every time,
or to relate to straight agencies, or man the hot
line. Rotate functions as much as possible.
Avoid the monotony and routinization of same-
ness. Some of your staff members may have left
the establishment business world just because it
was too routine for them. Let us not then trans-
plant these people into situations which are just
as routine. Let us not run the alternative institu-
tions in the same dehumanizing manner as the
business world runs itself.
A suggestion along these lines is if someone
shows signs of beginning a burn-out on a particu-
lar job, and you want to keep him working with
you, give him something entirely different to do
from his usual task.
4. Limit the number of hours a single person
works for you. Build in nine-hour shifts, if it is a
therapeutic community. Don't let people ex-
ceed their nine hours, except in cases of
emergency. If there are too many emergencies,
find out what is really taking place. Is a staff
member promoting emergencies in order to have
to work and stay longer? Or is it something that's
wrong in the facility? Make sure that no one
individual always works nights, for instance.
And stagger people's hours. If someone comes
in oftener than required or puts in more hours
than his share, find out why. Is it because he has
nothing else to do? Insist that people take their
time and evenings off. This also means that you
don' t always call the same people in for
"emergencies" or have them be on call. Time
off means time off.
If you are manning a rock festival, for exam-
ple, or because of crisis work you function on a
24-hour cycle, then a good idea is to have people
work six hours, rest two hours, work six hours,
rest two hours, and so on. But then, you must
insist that the two hours off be used to rest. If this
kind of pattern isn't insisted on, burn-out is very
rapid. If you are working at a rock festival,
burn-out can be compressed and condensed over
a three-day period. One time, at a rock festival, I
observed the same signs of burn-out within three
THE STAFF BURN-OUT SYNDROME 81
days as I saw in self-help groups after a year or
more.
5. If you are working in a collective, then a
sensible approach may be to work four weeks
and take the fifth week off. And in addition to
this, work three months and take the fourth
month off (with pay or shelter, of course). Also,
feel free to let the members of your group take
time off just because they want a night or a few
days for themselves.
6. It is very important for a group working
together to feel together as a group. This means
that no one member of the working force is
allowed to get so far out on his own that the other
members lose touch with him or he loses touch
with them. He may have, over a period of time,
gone so far away from the group that when he is
burning out, he cannot come back to reach out to
anyone.
7. Share your experiences with others and see
to it that your staff members share experiences
with one another. Talk about how you felt when
you were burning out. Listen to others who have
burnt out at one time or another.
8. It can be very helpful to give someone time
off to attend a workshop, as long as it is a learn-
ing experience and not an emotional encounter
experience. For one thing, this enables him to
get away for a while, to be in other surroundings.
And for another, he may find the workshop
stimulating, inspirational, and truly valuable to
his work. If you do not have the money to send
people away, then have workshops and training
sessions in your own institution from time to
time.
9. Also, to help avoid staff burn-out, you may
have to consider getting more volunteers. With
your present staff, too few people may be at-
tempting to do the work that requires many more
people.
10. Another good technique is to encourage
your staff and yourself as well to get in a lot of
physical exercise. If you want to run, then do it.
Engage in any activity that will make you physi-
cally tired. Many times the exhaustion of the
burn-out is an emotional and mental one. It is
this type of exhaustion that will not let you sleep.
That is why it is not always a good idea, in my
opinion, to shift into meditation, or yoga, which
cause a mental dropping inward. Introspection
is not what the burnt-out person requires. He
requires physical exhaustion, not further mental
strain and fatigue.
HOW TO HELP SOMEONE WHO HAS BURNED OUT
The first, most logical step to take would be to
ask the burnt out man or woman to take a long
rest away from the institution. If the institution is
a collective, he continues to be taken care of as
long as need be. If he is a volunteer, then have
him take the time away from the facility, even if
it is a month or more that he needs.
Of course, since there are various stages of
burn-out, any one of the preventive measures I
mentioned may also be used to help the person
who is in the process of burning out and who has
not yet quite burnt out completely.
Of utmost importance in helping someone to
overcome a burn-out support. He must have a
support group around him. He must be helped to
leave by people who love him for what he is and
who realize that the only way they can really help
him is to help him to see that he must leave for a
while. His leaving should be viewed by them as
positive. They should not make him feel it as a
failure on his part.
If burn-out comes as a consequence of a loss
of an ideal, then you most certainly need sym-
pathy and support. If your idealism, the very
motivation that lead you to come into an institu-
tion as a volunteer, has been lost, then the burn-
out has also within it the dynamics of mourning.
Something has died. There has been a real loss.
This loss may not only be the absence of some
good people whom you are no longer seeing as
regularly as before, but it may also be the loss of
something within yourself, something you trea-
sured and valuedyour ideals. You will then
need time to replenish that loss, to find new good
people to surround yourself with, new activities
to give you gratification. Such a burn-out is
difficult to overcome because it has been made
even more complicated by adding to exhaustion
both grief over the loss of your ideals and anger,
which is always present after grief.
As for me, I have always had an awareness of
the ever-present danger of burn-out and its
hazards. You might say that, as with a rattle-
snake, I have a healthy respect for the burn-out
phenomenon. It is a formidable enemy. A real
killer. I am always on the lookout for it. It is
something we can all be prone to. I myself have
been through it twiceonce in a free clinic set-
ting and another time in a therapeutic commu-
nity.
What is important to reflect upon is that some
82 HERBERT J. FREUDENBERGER
individuals, I believe, are driven to burn-out and
will always bum themselves out in one way or
another. There are some variations, however, in
burn-outs, even in the same individual. There
are, for example, longer periods between each
subsequent bum-out after the first. The first is apt
to happen quickly. But in time, you leam how to
pace yourself. You become more self-
protective, more cautious. You acquire more of
a self-interested attitude. You function more and
more on the outside of the facility. You move
more in the direction of being involved with and
yet in some way less intimately and emotionally
committed to the institution. But eventually you
may bum out again, only it takes longer this
time, and the burn-out is not so devastating. The
cycle seems to resemble the manic-depressive
cycle, except that burn-out is usually not as in-
tense or self-destructive, or as hard to prevent or
treat.
Just a few more brief words before closing.
This in regard to the burn-out of a whole agency.
In this instance, the total staff of one agency is so
"committed" and is so self-sacrificing that its
entire staff and resources burn out almost at the
same time. One solution to agency bum-out may
be for the agency to close shop for a while, to
take a vacation for a period of time, in order to be
able to re-evaluate itself, find out where it is
going, what it hopes to accomplish, whom it
wishes to help, and at what cost to itself. Some-
times a solution is to reorganize in terms of
priorities, energies expended, philosophical
orientation. Or a new leader may be the solution.
At other times, the agency's shutting down for
good may be the only solution to burn-out. It
may have accomplished what it set out to do, and
it now may have reached that point in its life to
close shop completely.
Solutions to burn-out are not simple, whether
they be on an agency or on an individual level.
The very nature of alternative institution work
almost guarantees that burn-out will take place.
Hopefully, we will in time leam better ways to
help people without its requiring such a terrible
cost not only to the helpers but to the numbers of
people in the communities who put their trust
and hope in those who perform the helping tasks.
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