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The Stress Doc Letter
Cybernotes from the Online Psychohumorist ™


AUG 2004, Sec. I

Fight when you can
Take flight when you must
Flow like a dream
In the Phoenix we trust!

Table of Contents

Shrink Rap
:        Stress Overture
Main Essay I:
      Are You Surviving the Burnout Battlefront?
Main Essay II:
     A Three-Step Model of Burnout Recovery
Readers:             Words to Live By

Section II

Main Essay III:   Prevention:  Natural SPEED and Psychological Hardiness 
Heads Up:
          Estrin Paralegal Superconference, PESI Health Care, Howard County                      Community College Health Fare, Indiana Univ. Kelley School of                      Business
           Training Kit, Books, CD and AOL Chat

Shrink Rap:

Stress Overture

This edition of the newsletter contains a new Shrink Rap and a three-part series on stress and burnout.  The rap was inspired by PR firm.  The first-part of this series has already been published by the Greater Los Angeles Assn. of Legal Administrators' Leadership Exchange, Aug 2004.  Wendy Sweet, Managing Editor, caught my live program at a conference in LA for Legal Administrators and invited a submission.  The series will also be appearing in slightly edited form in the newsletter of the Potomac Chapter/Professional Meeting Planners Intl.  The series draws on content from my new book:  Practice Safe Stress:  Healing and Laughing in the Face of Stress, Burnout, & Depression.  Speaking of which, the book has a cool new cover.  People in the bookbusiness/publishing industry thought my using Munch's image, "The Scream," was a bit too scary.  I'll be scanning in the cover on my website -- 
www.stressdoc.com .

On to the rap...

24/7 Rap

It's a "lean-and-MEAN" world that's 24/7
"Do more with less"
It's your mantra to heaven
Or to a promotion

So why so much whining and all the commotion?
You're job is essential
It's a matter of course
Unless shipped to India
And you've been outsourced.

But let's not be negative.
Get a grip on your rage.
Have faith in ol' Dubya.
He's sure to increase that minimum wage.

Or are the money and mortgage golden handcuffs?
Sorry -- anytime-anywhere
Never can be enough.

So forget that lifeline
Between work and home
Your soul has been transferred to a cellular phone.

Now the mind races when ear and cell are apart
And like a caged gerbil
You're turning purple, but
Proudly proclaiming right from the start
That blackberry burnout is your purple heart!

So what is the answer to this modern duress?
Should you try Prozac?
Is it time to confess?
To ebay shopping -- which may be a warning
When you're clicking madly at three in the morning.

Still, have no fear...
The Stress Doc is here to lay worries to rest
Now listen and learn to Practice Safe Stress!

Main Essay:  I

The Four Stages of Burnout: 
Are You Surviving the Burnout Battlefront?

Today's world is 24/7, wired and always on, often cycling between upgrading and reorganizing (if not outsourcing and downsizing).  And the company mantra:  "do more with less."  Big surprise…many folks are feeling "lean-and-MEAN" at the burnout battlefront.  But have no fear (well, maybe a little) the "Stress Doc" is here.  With insight, humor, and clear concepts and practical skills, this three-part series will help you survive and thrive in these turbulent times:
Part I:    The Four Stages of Burnout:  A Self-Assessment Tool
Part II:   A Three-Step Model of Burnout Recovery
Part III:  Developing Psychological Hardiness and Natural SPEED:  Prevention Strategies

The Erosive Spiral

The classic setup for burnout is a professional or personal situation that places ongoing high demands and responsibilities upon you while restricting your sense of control, autonomy and/or authority.  Inflexibly high expectations and elusive goals only add fuel to the fire.  Consider my Vital Lesson of the Four "R"s:  If no matter what you do or how you try, Results, Rewards, Recognition, and Relief are not forthcoming and you can't say and mean "No" or won't let go…trouble awaits.  The groundwork is being laid for apathy, callousness and despair.
Have I captured your attention?

Let me now provide a working definition:  Burnout is a gradual process by which a person detaches from work and other significant roles and relationships in response to excessive and prolonged stress and mental, physical, and emotional strain.  The result is lowered productivity, cynicism, and confusion…a feeling of being drained and having nothing more to give.  Whew!

It's time to examine some of the progressive signs of being caught up in this erosive spiral.  Here are "The Four Stages of Burnout":

1.  Physical, Mental, and Emotional Exhaustion.  Do you recognize this sequence?  Maybe you are still holding it together at work, but as soon as you get home it's right for the fridge.  You get out the Ben & Jerry's or the light beer, turn on the tube, hit the sofa, and then you're comatose for the rest of the evening.  Normally you pride yourself on doing a thorough job, a high quality performance.  But all the budget cuts have you looking for shortcuts, if not cutting corners.  And this gnaws at your self-esteem; maybe you waver between resentment and pangs of guilt.  A case of the "brain strain" is developing, accompanied by an energy shortage and feelings of exhaustion.  If stress continues unabated, you may be ripe for the second stage.

2.  Shame and Doubt.  At this stage, for example, when a supervisor asks you to take on a new assignment your first reaction is to be helpful, but suddenly a voice inside silently screams, "Who are you kidding!"  So what's happening?  You're feeling shaky in the present and losing confidence about managing the future.  You can even start discounting past accomplishments.  Remember, this is not a logical process but a psychological one.  Will colleagues, friends, or family members sense that something is wrong.  Are you being exposed as an impostor?

And then you catch yourself emitting heavy, labored sighs.  (When do people often engage in heavy, labored sighing and breathing…other than when calling those 1-900 numbers?  Just kidding.)  But seriously, the sighing stress smoke signal can occur when experiencing a deep sense of loss, or when ego-relevant change is perceived as uncontrollable.  Is chronically grappling with a profound sense of vulnerability or uncertainty your favorite state?  It's certainly not mine.  No surprise that some folks progress to the third phase:  "Cynicism and Callousness."

Are you starting to feel I've been looking in your window?  Don't bail out; two more stages to go.  And next we'll check out your "tude."

3.  Cynicism and Callousness.  Not surprisingly, in response to these vulnerable feelings some people put on their heavy armor.  Do these expressions sound familiar:  "Look out for # 1," "Cover your derriere," "Get out of my way,"  "No one's getting to me," and "That's that!"  And in the short run this strategy may work:  you become sufficiently abrasive people start avoiding you.  But over time this hard exterior can become a heavy burden.  Ironically, it's often "nice" people who like to accommodate others, that are susceptible.

What can't nice guys and nice gals do?  They can't say "No!"  They lack confidence in setting limits or establishing boundaries, especially with authority figures.  They are indiscriminately pleasing and often try to avoid conflict.  In moderation, being a people pleaser can be endearing and helpful; in excess it leads to dysfunctional relating and exhaustion.  Remember, burnout is less a sign of failure and more that you gave yourself away.  Not surprisingly, you can become resentful; people are taking advantage of you.  And the sensitive individual begins developing a calloused skin for self-protection.

And there's another salient issue.  Burnout doesn't just facilitate a hardening of the psyche, that hard attitude.  When your stress starts to smolder and turns to frustration, seething anger, and then "why are they trying to do this to me" mistrust…this is also a formula for a hardening of the arteries.  High blood pressure, hypertension, cardiovascular complications, even heart attacks and brain attacks (or strokes) are potential health risks.  Which is why, sometimes, I'd rather have people hit the fourth stage, than be trapped in the third:  "Failure, Helplessness, and Crisis."  While it sounds terrible, consider this:  hitting bottom means there's no more downward spiral.  And if you can reach out, there's nowhere to go but up.

4.  Failure, Helplessness, and Crisis.  Being caught in that "Career Catch-22" often signals the final stage:  Damned if you do; damned if you don't.  Damned if you stay, damned if you leave.  Your coping structure seems to be coming unglued.  Next stop, the Stress Doc's couch.  Hopefully not, but the crisis smoke signals are billowing big time.  Why is that?  Burnout is like trying to race a marathon - 26 miles, full speed, nonstop…no way.  Even Olympic marathon runners must pace themselves.  Without pacing the body parts wear out and the mental apparatus breaks down.  In fact, one reason the fourth stage is so disorienting psychologically is that there are cracks in your defensive armor.  Painful memories and old hurts, normally under cover, are pushing to the forefront of our consciousness, coloring our everyday perceptions.  Now a mate's occasional, somewhat annoying behavior really irritates as it reminds you of a mannerism of your father.  Or jealousy towards a colleague reeks of sibling rivalry.

Before throwing up your hands, remember, burnout is not for wimps.  A lot of other folks would have jumped ship much earlier.  Many reach the farther stages of burnout because of a sense of responsibility, tenacity, and dedication.  Noble qualities unless paired with a too rigid or "one right way" of thinking.  Then, especially in times of overload, uncertainty, and major change, a performance benefit can quickly turn into a professional liability.

And finally, there's the question of the millennium:  Why is Prozac and its chemical cousins so popular these days?  It's not rocket science, just plain medical science.  Prolonged stress over time will do a number on the functioning of your hormonal and biochemical systems, influencing the workings of such neurotransmitters as Serotonin.  Serotonin is instrumental in mood stability.  While these new psychotropic medications, especially when combined with counseling, bring real symptom relief for many (usually without adverse side effects) the moral is clear.  Prolonged stress over time can lead to mood instability, and even clinical depression, especially if there is some genetic predisposition, early childhood loss, or unresolved post-traumatic stress.

Fourth stage burnout is the crisis point; it's crunch time.  Are you ready to step up to the plate and reach out for the help and resources you need?  A person recovers and expands his or her strengths and possibilities through a crisis when:
1) getting proper support from a professional trained in crisis intervention and loss
2) confronting denial, false hopes, cynicism, and helplessness
3) grieving past and present losses while turning guilt and hurt, anxiety and aggression into focused energy
4) acquiring skills and technology for transforming new awareness and motivation

My poetic anthem to burnout and beyond:

For the Phoenix to rise from the ashes
One must know the pain
To transform the fire to burning desire.

Four stages of burnout.  Four steps for recovery and rejuvenation.  Are you ready to experience creative burnout?  Stay tuned to Part II for a burnout recovery model and until then…Practice Safe Stress


Main Essay:  II

Burnout Rejuvenation and Prevention -- Part II
Key Steps and Strategies

Part I of this three-part series examined "The Four Stages of Burnout":  1) Physical, Mental, and Emotional Exhaustion, 2) Shame and Doubt, 3) Cynicism and Callousness, and 4) Failure, Helplessness, and Crisis.  And while the erosive spiral can undermine energy, confidence, and even physical health, a burnout crisis can provide both danger and opportunity.  And the Stress Doc knows from personal experience.

Back in the 80s, I was a very unrealistic doctoral student trying to turn a mystical-like experience in psychoanalysis into a doctoral dissertation.  Several factors fired my questionable motivation:  a) a desire to discover a doctoral topic that wouldn't feel like an academic exercise, b) being driven to pursue a unique dissertation to compensate for long-standing feelings of intellectual self-doubt and unworthiness: I was going to "show them," i.e., those past and present skeptics, critics, and so-called authorities, and c) a still inchoate inner artist having a subliminal tug of war with my practical doctoral student persona.  For the sake of brevity, let's just say I was definitely off the academic wall.  As I would later write:  "Academic flashdancing definitely whirled to a burnout tango."   And for several months, I was laid low by exhaustion, existential emptiness, and stress-induced and frightening dizzy spells.

Fortunately, a silver lining emerged from the academic ashes.  I became an expert on stress and burnout eventually evolving a process of self-care that, I believe, can be instrumental for both burnout recovery and, even, prevention.  Consider these strategic steps for "R & R" - Rehabilitation and Rejuvenation:

1.  Good Grief.  While the burnout experience ultimately helped clarify my career path, it took several months to get out of the "Big Muddy" and "Big Moody."  I needed time to tend to my wounds.  Also, a major loss can undermine your sense of identity.  I needed to know that significant others still loved and respected me despite my feelings of academic failure and personal humiliation.   You may need a mentor or a counselor who can reconfirm your pre-crisis identity, who can see strengths when you are fixated on your weaknesses.  And you don't have to wait till you are in fourth stage burnout to start grieving.  In fact, recognizing the need to grapple with a changing reality or to question irrational or idealistically rigid expectations is a sign of ego strength.  And the earlier that one can grieve and "let go" the easier for emotional catharsis to become a burnout prevention tool as well as a base for rebuilding healthy purpose and passion.

2.  The Four "R"s of Burnout Recovery:  Running, Reading, Retreating, and Writing. 

(a) Running. After regaining my energy and balance, I started a regimen of daily jogging.  First, thirty-forty minutes of nonstop large muscle movement (jogging, brisk walking, cycling, swimming, etc.) will get those disposition-enhancing endorphins pumping.  The chemical influx helps slow a racing mind and helps lift a sluggish mood.  Also, running or jogging is great for grounding you when you're feeling vulnerable or when life feels uncertain and up in the air.  There's a beginning and end point culminating in a tangible sense of control and accomplishment.  This routine can readily evolve into a success ritual, a robust tool for both burnout prevention and recovery.

(b) Reading. In some of my darkest hours I turn to humorous novels or cartoon books (like Calvin and Hobbes) to add some absurdity, if not levity, to my perspective.  Hearty laughter also releases endorphins, giving vital organs a brief but vigorous internal massage.  As the erosive effects of burnout had spiraled, my playful and humorous mindset had withered.  How wonderful it was to laugh again and to chuckle at the irrationality of my outrageous egoal quest.  (What is an egoal?  Basically it is goal-seeking behavior that is driven by obsessive thinking and rigid, wounded, false, or self-righteous pride.)  Self-accepting laughter is a great antidote to embarrassment or shame.  And if reading still feels like a strain, turn on those Seinfeld reruns.

(c) Retreating. After my academic meltdown, I needed time to reflect on this ego-and identity-shattering process:  how and why had I generated this situational drama and psychophysiological trauma?  Retreating also allows time for engaging some existential biggies:  What are my skills, gifts, and talents?  What are my emotional, knowledge, and learning gaps?  What direction(s) and what enterprises really feel like me?  The blank canvas is scary.  There's no absolute way or preexisting structure.  The blank canvas is exciting.  There's no absolute truth or preexisting limits.  To paraphrase Walt Whitman:  Follow the open road and discover or recover your soul.

(d) Writing. Journaling through angst and loss is a time-honored tradition.  And contemporary research indicates that taking the time to express and analyze your emotions through writing provides a stress-relieving anchor in a stormy, troubled sea.  Reflective writing can also be a source of self-discovery -- a tool for your healing, understanding, and action, as well as a medium for keeping the faith. 

And one of my favorite ways to prepare for serious writing is by reading.  Reading for enlightenment followed the abovementioned lighthearted variety.  I started devouring books about burnout, and then began to write about it.  Actually, I wasn't quite ready to write directly about my dissertation meltdown.  However, in my therapy practice I was working with a couple of lawyers who were struggling with exhaustion and other serious smoke signals.  Analyzing their erosive spiral was cathartic.  And these writings even led to speaking at several legal conferences.  This academic lemon would make lemonade by becoming an expert -- therapist, writer, and lecturer - on stress and burnout...and spread the word far and wide.  (Obviously, once an egoal-driven narcissist…)

3.  Transition and Diversification.  The grieving path - from shock and sadness to fear and rage -- and the retreating process have three basic goals:  (a) to mourn and let go of a painful or problematic past or path, (b) to help you reenergize and refocus in the present and (c) to enable you to envision, design, and achieve a vital future.  As Nobel Prize-winning author Albert Camus observed:  "Once we have accepted the fact of loss we understand that the loved one [or loved position] obstructed a whole corner of the possible, pure now as a sky washed by rain."

And it's not just chronic overload or elusive goals that can be pathogenic, leaving us bereft.  Experienced professionals are often susceptible to what I call the Bjorn Bored Syndrome, named for Bjorn Borg, the late '70s-early '80-s Swedish tennis great.  After winning the French and Wimbledon championships five years back-to-back, Borg suddenly burned out and dropped out of the circuit.  Despite his many triumphs and the glamour of this stellar world, the novelty and thrill were gone.  The hours and hours of repetitive practice was taking a toll.  The Bjorn Bored Syndrome:  "When Mastery times Monotony provides an index of Misery!"  The Stress Doc's recommendation:  Fireproof your life with variety.

Recovering from burnout or rebuilding the fire means engaging in soul searching, shaking up the personal-professional puzzle, exploring anew, or even returning to one's passionate roots.  This might include such job or career path changes as:
(1) restructuring current roles and responsibilities; working in another department or division,
(2) taking a sabbatical; perhaps doing some extended travel,
(3) consulting independently or working for a foundation, an association, or an institute,
(4) going back to school to pursue a heartfelt interest, or even returning to the classroom as an educator,
(5) going into business for yourself or, if self-employed and running on empty, joining a company,
(6) recovering a previous creative pursuit and turning it into a career path or, perhaps, balancing a job with a passionate hobby, e.g., being a musician or a web programmer on the side, and
(7) pursuing a different professional setting or field, a new geographical location and, in some cases, even making a major "out of the career box" transition.  While one should carefully consult with family, friends, and advisors this period of reflection is also the time to listen not just to your head but also to your heart.

Final Reflection

Burnout evokes an experience of loss:  from loss of control or abandoning a cherished goal to a sense of helplessness and hopelessness.  However, wrestling with loss often yields new possibilities.  As I once penned:  Whether the loss is a key person, a desired position or a powerful illusion, each deserves the respect of a mourning.  The pit in the stomach, the clenched fists and quivering jaw, the anguished sobs prove catalytic in time.  In mystical fashion, like spring upon winter, the seeds of dissolution bear fruitful renewal.

Engaging with these three strategic steps will provide preventive fireproofing while enabling you, if necessary, to recover and rejuvenate from a burnout experience.  These ideas and actions will stimulate you to define and design your transitional future.  And finally, these are words to help us all…Practice Safe Stress!



Subj:  Words to Live By

From:  MDodick

1. "When I die, I want to die like my grandfather-who died peacefully in his sleep. Not screaming like all the passengers in his car." Author Unknown

2. Advice for the day: If you have a lot of tension and you get a headache, do what it says on the aspirin bottle: "Take two aspirin" and Keep away from children" Author Unknown

3. "Oh, you hate your job? Why didn't you say so? There's a Support group for that. It's called EVERYBODY, and they meet at the bar." Drew Carey

4. "Instead of getting married again, I'm going to find a woman I don't like and just give her a house," Rod Stewart

5. "The problem with the designated driver program, it's not a desirable job, but if you ever get sucked into doing it, have fun with it. At the end of the night, drop them off at the wrong house. Jeff Foxworthy

7. "If a woman has to choose between catching a fly ball and saving an infant's life, she will choose to save the infant's life without even considering if there is a man on base." Dave Barry

9. "Relationships are hard. It's like a full time job, and we should treat it like one. If your boyfriend or girlfriend wants to leave you, they should give you two weeks' notice. There should be severance pay, and before they leave you, they should have to find you a temp." Bob Ettinger

10. "My Mom said she learned how to swim when someone took her out in the lake and threw her off the boat. I said, 'Mom, they weren't trying to teach you how to swim." Paula Poundstone

11. "Why does Sea World have a seafood restaurant?? I'm halfway through my fish burger and I realize, Oh my God... I could be eating a slow learner." Lynda Montgomery

12. "I think that's how Chicago got started. A bunch of people in New York said, 'Gee, I'm enjoying the crime and the poverty, but it just isn't cold enough. Let's go west." Richard Jeni

13. "If life were fair, Elvis would be alive and all the impersonators could be dead." Johnny Carson

14. "Sometimes I think war is God's way of teaching us geography." Paul Rodriguez

15. "My parents didn't want to move to Florida, but they turned sixty, and that's the law." Jerry Seinfeld

16. "Remember in elementary school, you were told that in case of fire you have to line up quietly in a single file line from smallest to tallest. What is the logic in that? What, do tall people burn slower?" Warren Hutcherson

17. "Bigamy is having one spouse too many. Monogamy is the same. Oscar Wilde

18. "Suppose you were an idiot ... And suppose you were a member of congress...But I repeat myself." Mark Twain

19. "Our bombs are smarter than the average high school student. At least they can find Afghanistan." A. Whitney Brown

21. "Women complain about premenstrual syndrome, but I think of it as the only time of the month that I can be myself." Roseanne

23. "You can say any foolish thing to a dog, and the dog will give you a look that says, 'My God, you're right! I never would've thought of that!'" Dave Barry

24. Do you know why they call it "PMS"? Because "Mad Cow Disease" was taken.
Author Unknown, presumed dead.

Mark Gorkin, LICSW, "The Stress Doc" ™, is a keynote and international/Celebrity Cruise Lines motivational speaker, psychotherapist, syndicated writer, and author of his new book, Practice Safe Stress:  Healing and Laughing in the Face of Stress, Burnout & Depression and The Four Faces of Anger:  Transforming Anger, Conflict and Rage Into Inspiring Attitude and Behavior.  He was the keynote speaker for the Society of Human Resource Management (SHRM)--Maryland state chapters at their 2004 Leadership Conference.  The Doc, AOL's "Online Psychohumorist," is a training and OD Consultant for numerous companies, associations and government agencies.  Interviewed by the BBC and Biography magazine, Mark has a multi-award-winning, USA Today Online "HotSite" -- www.stressdoc.com .  The site was selected as workplace resource in a National Public Radio feature on "Bad Bosses."  For more info, email stressdoc@aol.com or call 202-232-8662.

(c)  Mark Gorkin  2004
Shrink Rap Productions