THE EXISTENTIAL CURE FOR BURNOUT
VIRTUE MEDICINE, P.C. ~ JANETA TANSEY, MD, PHD
CURING BURNOUT
AGENCY—Explore your
What is Burnout?
possibilities, seize choice
Burnout is a sustained experience
phase of life. Associated with
in which perceptions of
depression, anxiety, anger, and
powerlessness, isolation, and a
illness, burnout disrupts life’s joyful
AUTONOMY—Will to
loss of identity undermine our
and purposeful activities. And as
Power, not enslavement
beliefs in life’s meaning and
a hijacking of our ability to
purpose, and interfere with our
experience a well-lived life,
will to choose and act
persistent, severe burnout is a
authentically. Burnout, also
true existential threat. But this
described as demoralization,
paralysis in living is not without a
impacts the
personal,
social, spiritual
and physical
AS FAR AS WE CAN
DISCERN, THE SOLE PURPOSE
dimensions of
OF HUMAN EXISTENCE IS TO
our life, exists
KINDLE A LIGHT OF
on spectrum
of severity,
and can
MEANING IN THE DARKNESS
OF MERE BEING. —C.G. JUNG
AUTHENTICITY— Honor
yourself, for your sake
CURE, for a
RESPONSIBILITY—Will to
renewed
Meaning, with courage
sense of
power,
Honor your NEIGHBOR
identity,
belonging,
and
meaning in
HONOR TIME—Plan a
GOOD DEATH
life.
present in any
Persevere in SUFFERING
and ABSURDITY
THE EXISTENTIAL CURE
Live IN THE WORLD—
While not all cures are painful,
honoring what is good and true.
some can be, particularly when
Because the feelings and beliefs
they challenge inertia and
that accompany burnout are
demand a shift in perspective
pernicious and full of suffering,
Lean into the OPEN
that threatens cherished beliefs.
the process of curing isolation,
QUESTION
The interventions described here
powerlessness, and a loss of
are not passive, and they cure
identity requires compassion and
only insofar as they are applied
courage. Do invite both virtues
to free us from self-deception,
to the questions posed here, and
ignorance, and weakness of will,
remember that you are not
empowering us to engage in
alone in this very-human journey.
www.VirtueMedicine.com
Celebrate embodiment
BEING, NOT DOING—
Rediscover wonder
Virtue Medicine, P.C.
Ten existential principles are laid
freedoms. Many of us are
whole. Ask: What makes my life
out here. Each has a short
complicit with what Nietzsche
and my story, both its light and its
description, with challenge
called a slave morality. This is the
shadows, exist as beautiful,
questions for reflection and
naming and blaming of those
potent, purposive, and deep?
journaling. The questions may be
with power as vicious, while
What is my irreplaceable, unique
uncomfortable or feel foreign.
praising ourselves for “humbly,
mission? What would I believe if I
This is to be expected, as burnout
cunningly, patiently, wisely,
really knew myself as worthy of
is a serious condition, and an
cooperatively” submitting. This
honor and justice?
effective cure could never be
false morality appears when we
superficial. Some principles may
cultivate a perverse pleasure in
4: Responsibility. We live in a
strike closer to home than others,
pointing to our long-suffering or to
tension between what we are,
as we are not always struggling in
our “insightful” perception of
and what we are called to
all areas, but all ten are important
power inequities as sufficient to
become, still unaccomplished.
for both curing and preventing
virtue, rather than owning our
Clarity of vision about our
burnout, and worthy of attention.
ability and responsibility to step
authentic nature may not be
out of enslaving attachments
sufficient for action, even with
1: Agency. There is much about
and habits. Ask: When have I
ample choices and sufficient
the suffering of burnout that
put energy into blaming others,
freedom. Viktor Frankl states that
prompts a stubbornly
protecting my own inertia, fear,
since each of us is being
counterproductive conservation
or false modesty instead of
questioned by our very existence
of energies, making the same
owning my will to be master of
and the circumstances in which
choices over and over through
my own potential? What would I
we find ourselves, a Will to
habit and fatigue, circumventing
do if I abandoned a “slave”
Meaning is to courageously
a mindful intention to see and
narrative and chose to own my
answer for our own lives with
own our multiplicity of choices.
power to be a light in the world
concrete, real-time responses
But we are designed to be
without waiting for others to give
that satisfy our search for
agents of our own lives, and we
me space or permission?
significance. Each of us must
have the capacity to deliberate,
fulfill our own responsibility to and
to change, and to choose—and
3: Authenticity. To know oneself is
for ourselves in action. Ask: How
to do so with passion and
a lifetime project; we are storied,
can I better show a commitment
commitment. Ask: What possible
dynamic, evolving beings with
to my authenticity in my daily
choices have I discarded or
multiplicity, individuality, and
responses and choices? How
ignored or missed, and why?
depth. To conscientiously discern
would a courageous responsibility
What choices would I consider if I
our genuineness, with an
for what I have yet to accomplish
was not held back by fear? By
unfolding knowledge of who we
change the way I live today?
habit? By others’ expectations?
are and what we value, is to see
What choices would free me to
ourselves justly. Each of us is
5: Honor your Neighbor. The
be passionate, invested, and
unique and irreplaceable. And
isolation of burnout comes from
committed rather than merely
exercising compassion without
disruptions in our attachments to
cooperative?
shaming allows us to invite
others. Conserving our energies,
imagination, creativity, kindness,
we often restrict the power of
2: Autonomy. We are not
and wisdom to integrate our
other human beings to demand
infinitely free, but we have
complexities into its authentic
from us, giving disproportionately
Virtue Medicine, P.C.
to our own self-preservation. Of
demoralization and burnout take
do I have in the midst of that
course, there is a time for healthy
hold. Ask: What do I want my life
serious obstruction to define my
boundaries. But to allow others to
to demonstrate, celebrate, and
meaning, purpose, and joy? How
speak, to demand, to beseech,
create now, knowing that I will
can I cultivate inner peace
to challenge and sharpen, to
die? How am I actively investing
despite absurdity, and how is that
love and cherish, is the cure for
in my life’s finality, honoring my
an authentic act of my identity
the demoralization of solipsism.
potential, in the foreshadowing of
and will?
The cure is not without cost.
my death? What is my
When we honor our neighbors,
relationship with temporality, and
8: Live in the world, and
we allow them some power over
how do I embrace the gift of time
celebrate embodiment. While
us, and limit our freedoms. But
rather than trivialize its passing?
the natural world has certain
this dialogical space between
indignities, absurdities, and
self and other is the precious
7: Persevere in suffering and
suffering, we are inextricably
heart of the ethical life. Ask:
absurdity. Existentialism takes
connected to our physical
Who are the others to whom I am
seriously the challenge of our
existence. The pleasures and
uniquely accountable and
meaning in an impersonal,
wisdoms of living in our bodies
connected? How will I choose to
mechanistic, chaotic natural
should be embraced as part of
allow these others to speak into
world, with all its limits on our
living fully. Cultivating sensory,
my life, perhaps uncomfortably,
freedoms and causes of our
kinesthetic, and aesthetic
for the sake of my own purpose-
suffering. Rather than conflate
experiences are powerful
filled and meaningful existence?
our freedom and safety beyond
antidotes to burnout, orienting us
Where will I allow the other to limit
what is true, or abandon
in the world with such joys as
my freedoms, for the sake of
ourselves to nihilism, both of
beauty, music, deep sleep,
justice, and of love?
which will inevitably result in
warmth, calming breath, and all
demoralization, the challenge is
that goes with bodily ease and
6: Honor Time, and plan a good
to loosen our attachment to
satisfaction. Ask: What physical
death. Is there any deception
either-or dichotomies and submit
practices and comforts would
more pervasive than believing
as gracefully and powerfully as
help me bring back a sense of
that death always remains far
possible to living as both free and
harmony, meaning, and growth?
off? If so, perhaps it’s the
not-free. Camus had a very
How might I inhabit my spaces in
deception that we can wait until
specific image for us in The Myth
a more conscious, nurturing way?
tomorrow to do what needs be
of Sisyphus. Even though Sisyphus
done today, because we’re just
was doomed by the gods to roll
9: Unknowing and Not-knowing:
waiting for “a better time.” While
the boulder up the mountain
Curiosity and the Open Question.
we have no freedom to choose
forever—a suffering absurdity,
When we are burned out, it takes
in what time we live, nor to fully
Camus tells us that Sisyphus chose
a bit of radical courage to resist
choose the form of death, we
to be happy. The limits on our
organizing the world into tidy
often quietly pretend as if we do,
existence need not extinguish our
(false) answers and the empty
and this prevents us from
power to choose our attitude
reassurances that we crave,
designing our lives with a clear-
and to make meaning where we
particularly questions that are
minded awareness of our
will. Ask: Where is there an
associated with suffering. But
finiteness and finality, creating
unavoidable absurdity or
what burnout needs is a renewed
those little cracks where
suffering in my life? What choices
and childlike curiosity about what
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is not yet known, but full of
might come if I allowed myself to
ourselves permission to stop and
possibility. One of the most
consciously not-know for a while?
reconnect with the wonder of
powerful things we can do is look
being alive and full of possibilities.
for and lean into the open
10. Being, Not Doing. In all the
In fact, it is often in the quiet
questions for their promise of
activities of human perceiving,
space of surrendered and simple
growth, searching for depth of
believing, judging, willing, acting,
being that we find a renewed
meaning. A multiplicity of closed
feeling, and even in our
capacity to return to our work of
questions, or the too-easy “truth”
authentic commitments to a
authentic doing, but with lovely
constrains our awareness of
meaningful life, a kind of malaise
(not frantic!) rhythms. Ask: Am I
agency and our authenticity. Ask:
can occur with the effort of it all.
too busy? Is my burnout a
What easy or superficial answers
It may be that for some, the drive
function of mistaking productivity
have I accepted, when I should
for activity begins to function as
for meaning, or substituting a
be wrestling with what is not
an ersatz existence. We might
plethora of activities for true
known? How uncomfortable am
mistake the vigorousness of
individuality? What would
I with admitting to myself or
productivity for a life full of
happen to my sense of self and
others that I don’t know the
existential purpose, when in truth,
my will to power if I deliberately
answer? Can I practice a loving-
the quantity of our productivity is
chose to do less, but aligned
kindness and curiosity in NOT
so much less important than the
each choice more consciously
knowing, without falling into
depth of our authenticity. There
with my sense of purpose?
anger or despair? What relief
is a kind of loveliness in giving
IN CLOSING—AN INVITATION TO COMPASSION & COURAGE
One of my favorite works is Franz Rosenzweig’s “Little Book,” Understanding the Healthy and Sick. It
often comes to mind in my conversations about burnout, because of the encouraging and compassionate
way he speaks to his reader, whom he’s discerned is experiencing a paralysis of living. After he lays out the
truly challenging cure, similar in many ways to what I have suggested here, he invites rest before returning to
the labors of life, and offers a most compassionate and honest summary. “You must be a little frightened.
Contrary to our initial agreement, we have dealt with serious matters. Certainly they have become more
serious than you expected. The responsibility for that, however, does not rest with me. Life is a serious matter.
Ordinarily you are aware of this yourself. You would strongly resent it if your work, your actions and your
tribulations were not taken seriously. The things we have dealt with are of the same order of seriousness. They
are not more serious. But they are serious. At this point we must part company. I hope that I am not bidding
you farewell forever. We have had such a close acquaintanceship that I believe that many things remain to
be said. Whenever you are able to spare some time come and visit me at my home. You will be welcome.”
It is the nature of being human that we brush up against burnout’s potent paralysis periodically.
Sometimes it really takes root and needs an aggressive cure for our survival. And we are surrounded by other
persons in various states of similar paralysis, some of whom will be uncomfortable with our efforts towards
meaning, because of their own inertia, fear, self-deception, or bad faith. Take heart! You are not alone, your
existence matters, and on this journey towards a richer authenticity, I too bid you a warm welcome. Join me.
Janeta Tansey, M.D. Ph.D. is a physician, ethicist,
and professional-executive coach in Iowa City,
Iowa, specializing in existential and humanistic care.