An Integrative Approach to Caregiver Burnout

Co-written with Clark Maxon.

Burnout is a state of physical or mental exhaustion that results from prolonged or excessive stress. Job burnout can be affected by staffing shortages and long work hours, which can cause a person to feel overwhelmed, emotionally drained, and unable to keep up with demands.

The World Health Organization has defined burnout as an occupational phenomenon, but it can happen in other contexts, such as caring for ailing family members, as well. Caregiver burnout involves the physical, emotional, and mental exhaustion that takes place while you’re taking care of someone else and can include anxiety and depression.

How Common Is Burnout?

Burnout affects people in a wide range of careers. Some of the highest rates of burnout are seen among doctors, nurses, teachers, mental health workers, retail workers, construction workers, and certified public accountants. But burnout can occur in any career. Women are more likely to feel burned out than men, which may be due to the fact that women are overrepresented in occupations such as education and health care.

According to Gallup, burnout has been increasing globally for more than a decade and now sits at an all time high. More than 40 percent of workers report feeling burned out, which is the highest rate since May 2021.

In June of 2020, the American Psychological Association surveyed 5470 people and found that 67% of the 40 million Americans acting as unpaid caregivers (caring for ailing family members) reported at least one adverse mental or behavioral symptom in the previous 30 days. They also found that caregivers, compared to those not taking care of ailing family members, were at least 3 times more likely to report substance abuse and 8.5 times more likely to report serious suicidal ideation.

What Are the Holistic Impacts of Burnout?

Burnout has well established impacts on emotional well-being, mental functioning, and physical health (mind and body). The chronic stress associated with burnout also impacts the facets of life that are often associated with spirituality, such as hope, meaning, purpose, and connection (spirit).

Dis-integration, through denial or neglect of physical, emotional, and spiritual wellness, increases the stress load experienced by caregivers. Burnout, and the unpleasant emotions that go with it, can distort the way we see ourselves and others in our world. This distorted perspective contributes to reduced mental, physical, and spiritual health. Some potential signs of burnout include:

• Mind: Inability to concentrate and perform mental tasks, impaired judgment, and cognitive distortions like self-criticism, self doubt and excessive guilt, worry/rumination, reduced interest, joy, and motivation
• Body: Fatigue, increased incidence of physical symptoms and illness
• Spirit: Hopelessness, decreased capacity for compassion toward self and others, diminished sense of purpose and meaning

How Can We Overcome Burnout?

The impacts of caregiver burnout can be powerfully addressed through the intentional integration of mind, body, and spirit. We propose FACE as a model process that addresses the difficult emotions experienced by caregivers. FACE integrates mind, body, and spirit in an evidence-based approach that does not depend on any particular religious or spiritual beliefs or practices. By accepting, processing, and understanding our difficult emotions, these emotions can become helpful messages that can help keep us well in mind, body, and spirit. FACE can be practiced “on the go,” in the moment, or by taking some time alone when the emotion represents a significant challenge.

FACE the emotions

Feel the emotion

• Find the sensations in your body
• Let go of thoughts and stories
• Describe the sensations (keeps the mind on target)
• Keep returning focus to the body
• Notice how the sensations change

Allow the emotion

• Name the emotions(s) and accept it as reality. “In this moment I am experiencing _____.”

Burnout Essential Reads

What Interventions Are Effective for Psychologist Burnout?

The Truth About Burnout

Curiosity: the antidote to judgmentalism

• Wonder about causes
• Wonder about context

Express compassion toward self and others

Expressing Self Compassion

In order to express self compassion, try the following:

• Acknowledge that this is a time of suffering in mind, body, and spirit
• Acknowledge that we all experience suffering. We are not alone in our suffering.
• Express loving kindness toward yourself.

Loving Kindness Menu

Pay attention to acts of loving kindness that restore your soul and spiritual clarity.

Body:

• Provide yourself what you need in the moment — sleep, food, exercise that's enjoyable
• Try self-soothing — give yourself a hug, rub your thighs, massage your head
• Get a massage
• Adjust your diet — try intermittent fasting and ketogenic diet to reduce inflammation
• Practice a self compassionate body scan

Mind (mental and emotional):

• Validate the difficult situation — this is hard, upsetting, painful, etc.
• Offer genuine self-encouragement — “This may not be what I prefer and I know, but it will be okay,” “I can do this,” “I got this,” etc.
• Imagine what a loving friend would say — say it to yourself
• Practice healthy boundaries
• Practice kind assertiveness — ask for what you need
• Try a mindfulness practice — eat like a connoisseur, triangle breathing, physiological sigh, savor a cup of tea, go on a beauty hunt
• Practice intentionally accepting what is
• Practice curiosity

Spirit:

• Take a walk outside and connect with the natural world
• Make a gratitude list
• Take time to consider how your current suffering may become transformative for wisdom
• Notice your natural compassionate response to suffering (self and others)
• Take time for prayer, meditation, or a favorite spiritual practice
• Offer and receive acts of service unrelated to specific caregiver duties

Summary

By FACEing the emotions associated with burnout, expressing self-compassion, and practicing loving kindness toward ourselves and others, we can overcome burnout and regain our physical, mental, and spiritual health.

Clark Maxon, MA, LPCC, NCC is a therapist at Mayfield Counseling Centers in Colorado Springs. Prior to this position, he served as the founding program coordinator for the Family Resource Center in Academy District 20 to provide no-cost mental health counseling for students. He has also provided consulting services for other local school districts to develop mental health counseling services for students.