Who takes care of theWho takes care of thecaretaker?caretaker?
Burnout prevention for the helpingBurnout prevention for the helpingprofessionalsprofessionals
Dr. Yaron Ziv, MSW, Psy.DDr. Yaron Ziv, MSW, Psy.D
MaofMaof--center for human developmentcenter for human development
www.yaronziv.comwww.yaronziv.com
Burnout and stress at workBurnout and stress at work --difficulty and challengedifficulty and challenge
No person is immune againstNo person is immune againststressstress
No person is immune againstNo person is immune againstburnoutburnout
Stress and burnout areStress and burnout arenormative situations for thenormative situations for themodern working peoplemodern working people
Burnout and stress at workBurnout and stress at work --difficulty and challengedifficulty and challenge
Our task is:Our task is:
1.1. IdentifyIdentify
2.2. Take responsibilityTake responsibility
3.3. Take actionTake action
The ratio of burnout among theThe ratio of burnout among thetherapeutic profession, is one oftherapeutic profession, is one ofthe highest on the scale, 6the highest on the scale, 6thth
position out of 140 professions.position out of 140 professions.
What is stress?What is stress?
SituationSituation perceivedperceived as a threatas a threat(Selie,1961)(Selie,1961)
Situation in which a gap betweenSituation in which a gap betweenperceivedperceived selfself--expectation andexpectation andperceivedperceived environment expectationenvironment expectationoccurs (Ziv,1999)occurs (Ziv,1999)
What is stress?What is stress?
Situation in which a gap betweenSituation in which a gap betweenperceivedperceived demands and existingdemands and existingresources occurs (Folkmanresources occurs (Folkman&Lazarus, 1984)&Lazarus, 1984)
Situation in which negative energySituation in which negative energyis invested at presenceis invested at presence( now( now) in) inregard ofregard of perceivedperceived thoughts aboutthoughts aboutthethe futurefuture (Ziv,2004)(Ziv,2004)
What is stress?What is stress?
PerceptionPerception is the key word inis the key word inregard to stress.regard to stress.
““stressful situationstressful situation”” doesndoesn’’t existt exist
What is perceived as stress to oneWhat is perceived as stress to onewill not be perceived as stress towill not be perceived as stress toanotheranother
Stress is not good or bad , whatStress is not good or bad , whatcounts is the level of stresscounts is the level of stress
Negative ways to cope with stressNegative ways to cope with stress
DrugsDrugs
AlcoholAlcohol
SleepSleep
AvoidanceAvoidance
ProcrastinationProcrastination
EatingEating
AngerAnger
Positive ways to cope with stressPositive ways to cope with stress
SportSport
Good NutritionGood Nutrition
Meditation, Relaxation, Yoga,Meditation, Relaxation, Yoga,
Sharing and encountering withSharing and encountering withfriendsfriends
Good time managementGood time management
AssertivenessAssertiveness
Positive thinkingPositive thinking
What is Burnout?What is Burnout?
BurnoutBurnout is an accumulatedis an accumulatedprocess of physical and mentalprocess of physical and mentalfatigue as a result offatigue as a result ofaccumulated situations ofaccumulated situations offrustrations that have not beenfrustrations that have not beenresolved (Maslach,1998)resolved (Maslach,1998)
Physical symptoms of BurnoutPhysical symptoms of Burnout
Somatic complains about fatigue,Somatic complains about fatigue,dizziness, headaches, tensiondizziness, headaches, tension
Decline of the Immune systemDecline of the Immune systemfunctioningfunctioning
High exposure to heart and cancerHigh exposure to heart and cancerdiseases.diseases.
Cognitive symptoms of BurnoutCognitive symptoms of Burnout
Damage to the STM.Damage to the STM.
Forgetting the keys in carForgetting the keys in car
CanCan’’t find the keys in the morningt find the keys in the morning
Inability to invest energy inInability to invest energy inanythinganything
Cynicism and cynical humorCynicism and cynical humor
SarcasmSarcasm
Cognitive symptoms of BurnoutCognitive symptoms of Burnout
Setting appointments to differentSetting appointments to differentpeople on the same timepeople on the same time
Forgetting where you put yourForgetting where you put yourcalendar of appointmentscalendar of appointments
Loss of creativityLoss of creativity ––””working by theworking by thebookbook””
Social symptoms of BurnoutSocial symptoms of Burnout
IsolationIsolation and alienationand alienation
““the whole world is against methe whole world is against me””
Deliberate damaging the workDeliberate damaging the work
Low frustration tolerance to otherLow frustration tolerance to otherpeoplepeople’’s behaviors behavior
Negative attitude towards otherNegative attitude towards otherpeoplepeople
Putting down, ridicule other peoplePutting down, ridicule other people
Emotional symptoms of BurnoutEmotional symptoms of Burnout
DepressionDepression
AngerAnger
DepersonalizationDepersonalization
ImperviousnessImperviousness
Coping and preventing BurnoutCoping and preventing Burnout
Always learn something newAlways learn something new
Learn something which is notLearn something which is notconnected to your professionconnected to your profession
Create opportunities to share yourCreate opportunities to share yourfeelings and thoughts with othersfeelings and thoughts with others
Enrich your work, donEnrich your work, don’’t do thet do thesame thing for too long timesame thing for too long time
Coping and preventing BurnoutCoping and preventing Burnout
Balance between work and privateBalance between work and privatelifelife
Make physical exercise as a regularMake physical exercise as a regularhabithabit
Make time for relaxation and musicMake time for relaxation and music
Love what you do and do what youLove what you do and do what youlovelove
““if you are not there, quit!!!if you are not there, quit!!!””
Burnout among therapistsBurnout among therapists
The Therapeutic contract isThe Therapeutic contract isdifficultdifficult
The client is allowed to project onThe client is allowed to project onhis/her therapist (his/her therapist (transferencetransference), but), butthe therapist is not allowed tothe therapist is not allowed toproject on his/her clientproject on his/her client(countertransference(countertransference), it is), it isconsidered non professionalconsidered non professionalbehaviorbehavior
The therapeutic contractThe therapeutic contract
Every therapist serves as aEvery therapist serves as aprojected objectprojected object
Skills like empathy, activeSkills like empathy, activelistening, unconditional acceptancelistening, unconditional acceptanceare not natural and they requireare not natural and they requireenergy investment.energy investment.
TheThe ““savior symptomsavior symptom”” –– ““I willI willsucceed where everybody elsesucceed where everybody elsefailedfailed””
The therapeutic relationshipThe therapeutic relationship
We do it because we careWe do it because we care
We have to keep boundaries and toWe have to keep boundaries and todistinguish betweendistinguish between identificationidentificationandand empathyempathy
If you realize that youIf you realize that you ““take it intake it in””,,notice that there is annotice that there is an ““unfinishedunfinishedbusinessbusiness”” –– share it with yourshare it with yourtherapisttherapist
The energy bankThe energy bank
We do function in our life out of anWe do function in our life out of anenergy bank that operates like aenergy bank that operates like aregular bank.regular bank.
We have energy deposits and weWe have energy deposits and wehave energy withdrawalshave energy withdrawals
The only difference between theThe only difference between theenergy bank and the regular bankenergy bank and the regular bankthat we canthat we can’’t get loans!!!t get loans!!!
The energy bankThe energy bank
Burnout is defined as a continuousBurnout is defined as a continuousoverdraftoverdraft
It is very important to check regularlyIt is very important to check regularlyour balanceour balance
To maintain good balance in our energyTo maintain good balance in our energybank, we need to make sure that therebank, we need to make sure that thereare enough energy deposits in theare enough energy deposits in theaccount and we are in control of ouraccount and we are in control of ourenergy withdrawalsenergy withdrawals
The energy bankThe energy bank
What is an energy deposit?What is an energy deposit?
Energy deposit is any action we doEnergy deposit is any action we dototo ““charge batteriescharge batteries”” for fun andfor fun andpleasure: dancing, going to concertspleasure: dancing, going to concertsplaying cards, hanging out etc.playing cards, hanging out etc.
Notice that every energy deposit isNotice that every energy deposit isa time invested act, we need toa time invested act, we need toimplement it into our weeklyimplement it into our weeklyscheduleschedule
The energy bankThe energy bank
What is an energy withdrawal?What is an energy withdrawal?
An energy withdrawal is anAn energy withdrawal is aninvested energy in one of theinvested energy in one of thefollowing acts: Anger,following acts: Anger,Disappointment, Worry, Stress,Disappointment, Worry, Stress,Fear, Anxiety, Hurt, Tension, Guilt,Fear, Anxiety, Hurt, Tension, Guilt,Shame, etc.Shame, etc.
Some withdrawals are unavoidableSome withdrawals are unavoidable
Some withdrawals can beSome withdrawals can be ““savedsaved””
The energy bankThe energy bank
Make a list of energy deposits andMake a list of energy deposits andwithdrawals on a weekly basis atwithdrawals on a weekly basis athome and at workhome and at work
Notice which withdrawals areNotice which withdrawals areunavoidable and which can beunavoidable and which can besaved.saved.
Share with your partnerShare with your partner
The energy bankThe energy bank
Notice how many deposits you putNotice how many deposits you putin your accountin your account ––if any!!!if any!!!
If you are the last on the listIf you are the last on the list-- whatwhatdoes it say about yourself?does it say about yourself?
If your withdrawals are much moreIf your withdrawals are much morethan your depositsthan your deposits-- what does itwhat does itmean for you?mean for you?
Are you the captain of your energyAre you the captain of your energyship?ship?
The energy bankThe energy bank
What energy withdrawals can beWhat energy withdrawals can be““savedsaved””??
All the energy withdrawals thatAll the energy withdrawals thatrelate to Anger, Frustration, Hurt,relate to Anger, Frustration, Hurt,and Disappointmentand Disappointment
These invested energy have oneThese invested energy have onething in common :thing in common :EXPECTATIONEXPECTATION
Let us talk about expectationsLet us talk about expectations
Nobody can make us angry!Nobody can make us angry!
Nobody can disappoint us!Nobody can disappoint us!
Nobody can hurt us!Nobody can hurt us!
Nobody can frustrate us!Nobody can frustrate us!
We make ourselves angryWe make ourselves angry
We disappoint ourselvesWe disappoint ourselves
We make ourselves hurtWe make ourselves hurt
We make ourselves frustratedWe make ourselves frustrated
Let us talk about expectationsLet us talk about expectations
How do we do it?How do we do it?
We make ourselves angry or hurt orWe make ourselves angry or hurt ordisappointment not because peopledisappointment not because peopledid something or didndid something or didn’’t dot dosomething.something.
Our emotions is ours therefore weOur emotions is ours therefore weare responsible for their existanceare responsible for their existance
Let us talk about expectationsLet us talk about expectations
we get angry, hurt, disappointedwe get angry, hurt, disappointedbecause people do or donbecause people do or don’’t dot dosomething that doesnsomething that doesn’’t go alongt go alongwith our expectations.with our expectations.
TheyThey shouldshould have done this or theyhave done this or theyshould notshould not have done thathave done that
II cancan’’t standt stand that he/she does it thatthat he/she does it thatwayway
Let us talk about expectationsLet us talk about expectations
Common words about expectations:Common words about expectations:High/low, justified, minimal,High/low, justified, minimal,obvious, all these words areobvious, all these words arerelatively phrases and thereforerelatively phrases and thereforelead to nowhere!lead to nowhere!
What is obvious for me is notWhat is obvious for me is notobvious for youobvious for you
We need not toWe need not to ““lowerlower”” ourourexpectations ratherexpectations rather ““adjustadjust”” themthem
Two kinds of expectationsTwo kinds of expectations
We have two kinds of expectations:We have two kinds of expectations:legitimate and realistic.legitimate and realistic.
A legitimate expectation doesnA legitimate expectation doesn’’ttrelate to a certain individual or to arelate to a certain individual or to acertain time, legitimate expectationcertain time, legitimate expectationis manifested out of values, ethics,is manifested out of values, ethics,attitudes, norms and cultureattitudes, norms and culture
A realistic expectation relates toA realistic expectation relates topeople and time.people and time.
Two kinds of expectationsTwo kinds of expectations
There are three options: expectationsThere are three options: expectationscould be non legitimate and non realisticcould be non legitimate and non realistic
Expectations could be legitimate andExpectations could be legitimate andrealisticrealistic
Expectations could be legitimate but notExpectations could be legitimate but notrealisticrealistic
I doesnI doesn’’t matter if the expectations aret matter if the expectations arelegitimate if they are not realistic itlegitimate if they are not realistic it’’s as awaste of energy. WOEwaste of energy. WOE-- Waste OfWaste OfEnergyEnergy
Two kinds of expectationsTwo kinds of expectations
How do we know if an expectationHow do we know if an expectationis realistic or not? Can it beis realistic or not? Can it befulfilled in thefulfilled in the existing realityexisting reality??
Rational Vs Irrational thoughtsRational Vs Irrational thoughts
ABC moduleABC module ––(Albert Ellis, Ph.D)(Albert Ellis, Ph.D)
RationalRational ––Emotive BehavioralEmotive Behavioraltherapy, REBT.therapy, REBT.
Common Irrational thoughtsCommon Irrational thoughtsamong therapistsamong therapists
II shouldshould have known how to helphave known how to helpthis client, Ithis client, I shouldshould have donehave donebetter.better.
If I donIf I don’’t succeed to help this clientt succeed to help this clientthat meansthat means I am a lousy therapistI am a lousy therapist
If my client is not satisfied with myIf my client is not satisfied with mytherapy ittherapy it mustmust be my fault.be my fault.
Common Irrational thoughtsCommon Irrational thoughtsamong therapistsamong therapists
If I set boundaries to my client I amIf I set boundaries to my client I amaa ““badbad”” therapisttherapist. Good therapist. Good therapistshouldshould be always to the service ofbe always to the service oftheir clientstheir clients
If I disagree with my client IIf I disagree with my client I am notam notreal empathetic, caring,real empathetic, caring,professional therapistprofessional therapist
Common Irrational thoughtsCommon Irrational thoughtsamong therapistsamong therapists
II cancan’’tt take vacations , time off, it istake vacations , time off, it ison the account of my clientson the account of my clients’’ needs.needs.
My clients needsMy clients needs shouldshould be morebe moreimportant than my own needsimportant than my own needsbecause they arebecause they are ““weekweek”” and I amand I am““strongstrong””..
If my client is not satisfied thatIf my client is not satisfied thatshowsshows what a lousy university Iwhat a lousy university Iwent towent to
The 40 minutes formulaThe 40 minutes formula
Balance between work and privateBalance between work and privatelife.life.
40 minutes are 2/3 of an hour.40 minutes are 2/3 of an hour.
If we take 4 times 10 minutes ofIf we take 4 times 10 minutes oftimetime--out, it will change our day.out, it will change our day.
If we make it part of our regularIf we make it part of our regularenergy deposit, our energy bankenergy deposit, our energy bankwill look different.will look different.
The 40 minutes formulaThe 40 minutes formula
11stst timetime--out: the morning time outout: the morning time out
22ndnd timetime--out: before wearing theout: before wearing theuniformuniform
33rdrd timetime--out: close the gate behindout: close the gate behindyouyou
44thth timetime--out:out:”” my home is mymy home is myfortressfortress ““
The 40 minutes formulaThe 40 minutes formula
home work
t.o1 t.o2
t.o3t.o4
The magic of lifeThe magic of life
““Life is the longest loan thatLife is the longest loan thatdeath gave usdeath gave us””-- SocratesSocrates
Enjoy life and celebrate,Enjoy life and celebrate,Everyday that passes doesEveryday that passes doesnot return.not return.
The magic of lifeThe magic of life
Life is the show for itselfLife is the show for itself
There are no rehearsalsThere are no rehearsals
Thank you for attendingThank you for attendingyaronyaron