Role Strain and Burnout: It’s Not Just Me . . . or the Job | July 2023

“Burnout” is among the phrases that have become more widely used and recognized since the beginning of the Covid-19 pandemic. Dr. Herbert Freudenberger first coined this term (Maslach & Schaufeli, 1993) as a result of his work at free clinics serving individuals struggling with drug addiction (Hoffarth, 2017). There, he observed symptoms of severe exhaustion, health issues, and increasing cynicism and anger in clinicians, patients, and himself (Freudenberger, 1974). Later, researchers would further analyze burnout and translate it into an assessment, known as the Maslach Burnout Inventory, which includes measures of emotional exhaustion, depersonalization, and decreased feelings of personal accomplishment (Maslach & Leiter, 2021). Although burnout is arguably a psychological condition with physical effects, it can also be analyzed sociologically (Varpio et al., 2018).

From a sociological perspective, factors contributing to burnout include culture, norms, and environment. In the workplace, these factors include workload, sense of control, reward for effort, fairness, and alignment of values (Maslach & Leiter, 1997). In broader societal culture, factors such as norms around work/life balance, status associated with being driven and high achieving, and stigma around discussing mental health in the workplace impact burnout (Elraz, 2018). Looking back to the late 1800s, the concept of neurasthenia, characterized by similar symptoms of burnout, was observed in society’s high achievers afflicted with social and interpersonal distress (Lipsitt, 2019). Scholars have pointed out that the social norms of the time associated this condition with positive traits, such as being hardworking and dedicated to one’s work. 

The sociological concept of role strain adds to our understanding of how burnout manifests in individuals. Role strain is at the intersection of the self and society, referring to a clash among the multiple social roles that we fulfill (Goode, 1960). A social role is essentially a set of norms and expectations of behavior. For example, the social role of a parent might include providing emotional and financial support to children. In contrast, the social role of an employee might include managing work responsibilities, complying with administrative expectations, and adhering to organizational hierarchy. Most individuals in society are juggling multiple roles within their home, social life, and work.

During the recent pandemic years, boundaries of social roles became blurred, with clashing expectations and an exacerbation of role strain. For example, 40% to 60% of health professionals experienced burnout during the pandemic. They dealt with equipment shortages, patient distress and mortality, interactions with family, long hours, moral distress, powerlessness, and increased anxiety and depression (Guttormson et al., 2022). Their roles at work clashed with other social roles such as parent, caregiver, and even teacher. In addition to hardships from potential quarantining away from family, their work roles reduced time and emotional support available to cope with the impact of strain on family and social life. These conditions were a perfect storm for burnout.

Ultimately, burnout is a persisting condition with psychological and sociological factors. The sociological perspective can contribute to our understanding of how our systems and cultures can contribute to prevention and recovery from burnout. It can broaden solutions from interventions focused solely on the individual. Factors such as interpersonal relationships, social support, social norms and culture, and organizational climate can all impact the effects of role strain and can be protective against burnout (Lim et al., 2010). At the organizational level, workplaces can integrate employee appreciation and bolster social support that includes discussion around family and other interpersonal relationships (Varpio et al., 2018). Structurally, this could look like bolstered family medical leave and paid sick leave that supports work-life balance. At the policy level, key support structures can be integrated, such as universal healthcare, increased access to mental healthcare, increased paid maternal and paternal leave, and debt relief. And at the cultural level, we can begin to normalize struggles and reduce stigma around burnout. Shifting perception of burnout as a personal problem or deficiency, to a public issue with physical and psychological effects, can help shift solutions further upstream to address the roots of burnout. In turn, these efforts can improve mental health, employee retention, job satisfaction, quality of life, and our collective well-being.

Discussion Questions:

How might role strain manifest in your life? What are your social roles, and how might they conflict with each other in a way that impacts your well-being?

What policies or programs could be implemented at your school or workplace to prevent or address burnout? 

What social norms affect burnout? Do you see these norms as changing?

References:

Elraz, H. (2018). Identity, mental health and work: How employees with mental health conditions recount stigma and the pejorative discourse of mental illness. Human Relations, 71(5), 722–741.

Freudenberger, H. J. (1974). Staff burn-out. Journal of Social Issues, 30, 159–165.

Goode, W. (1960). A theory of role strain. American Sociological Review, 25(4), 483.

Guttormson, J. L., Calkins, K., McAndrew, N., Fitzgerald, J., Losurdo, H., & Loonsfoot, D. (2022). Critical care nurse burnout, moral distress, and mental health during the COVID-19 pandemic: A United States survey. Heart & Lung, 55, 127–133.

Hoffarth, M. J. (2017). The making of burnout: From social change to self-awareness in the postwar United States, 1970–82. History of the Human Sciences, 30(5), 30–45.

Lim, N., Kim, E. K., Kim, H., Yang, E., & Lee, S. M. (2010). Individual and work‐related factors influencing burnout of mental health professionals: A meta‐analysis. Journal of Employment Counseling, 47(2), 86–96.

Lipsitt, D. R. (2019). Is Today’s 21st Century Burnout 19th Century’s Neurasthenia?. The Journal of Nervous and Mental Disease, 207(9), 773–777.

Maslach, C., & Leiter, M. P. (2021). How to measure burnout accurately and ethically. Harvard Business Review, 7.

Maslach, C., & Leiter, M. P. (1997). The Truth About Burnout: How Organizations Cause Personal Stress and What to Do About It. San Francisco, CA: Jossey-Bass.

Maslach and Schaufeli, “Historical and Conceptual Development of Burnout.” In Professional Burnout: Recent Developments in Theory and Research, ed. Wilmar Schaufeli, Christina Maslach, and Tadeausz Marek (Washington, DC: Taylor & Francis, 1993), 1–16.

Jalili, M., Niroomand, M., Hadavand, F., Zeinali, K., & Fotouhi, A. (2021). Burnout among healthcare professionals during COVID-19 pandemic: a cross-sectional study. International Archives of Occupational and Environmental Health, 94, 1345–1352.

Varpio, L., Ray, R., Dong, T., Hutchinson, J., & Durning, S. J. (2018). Expanding the conversation on burnout through conceptions of role strain and role conflict. Journal of Graduate Medical Education, 10(6), 620–623.