“Burn-out” As A Medical Condition

Every few years, the World Health Organization produces a new version of the International Classification of Diseases, a catalog of acknowledged medical conditions that is used as a diagnostic guide by health care providers.  With every new version of the ICD, there seems to be some controversy about whether or not a particular ailment or complaint should be recognized.

burnoutThis year, the “should it be included or not” controversy swirls around “burn-out.”  Apparently there has been a long, ongoing debate about whether “burn-out” should be recognized as a medical condition, and the WHO has now weighed in with a “yes”:  the ICD-11 lists “burn-out” and defines it as “a syndrome conceptualised as resulting from chronic workplace stress that has not been successfully managed.”  According to the WHO, “burn-out” syndrome is characterized by “1) feelings of energy depletion or exhaustion; 2) increased mental distance from one’s job, or feelings of negativism or cynicism related to one’s job; and 3) reduced professional efficacy.”  Notably, the ICD-11 tries to draw a kind of line in the sand by stating that “burn-out” “refers specifically to phenomena in the occupational context and should not be applied to describe experiences in other areas of life.”

My guess is that many — if not all — workers have, at some particular point or another in their careers, experienced “burn-out” as defined by the WHO.  Jobs typically involve stress, and it’s almost inevitable that there will be periods where multiple obligations pile on top of each other, leaving the worker feeling overwhelmed, exhausted, and dissatisfied.  But . . . should “burn-out” be viewed as a medical condition?  What, exactly, is a doctor supposed to do for a patient who presents with classic “burn-out” symptoms — prescribe a three-month vacation, or a new job, or new job responsibilities, or a change in the patient’s workplace manager?  Will employers be required to allow leaves of absence, beyond their designated vacation periods, for employees whose doctors diagnose them with “burn-out,” and will health insurers be required to pay for vacations as a form of treatment?  By classifying “burn-out” as a diagnosable health condition, aren’t we really going far down the road of “medicalizing” common aspects of our daily lives?

And can “burn-out” really be limited to the “occupational context,” as the ICD-11 instructs, or will the same concepts underlying workplace “burn-out” ultimately be recognized in other areas, like family or marital or college “burn-out”?  Here’s a possible answer to that question:  the ICD-11 now recognizes video gaming, with cocaine, and alcohol, and gambling, as a potential source of addiction.

When Employers Go Too Far

It’s pretty common for people to squawk about their employers.  Usually the bitching seems almost rote — a simple byproduct of the friction and unequal power relationship between underling and boss, huge corporation and cubicle dweller.  The company they work for isn’t evil, it’s just faceless and bureaucratic.  Sometimes, though, companies get . . . well, downright weird.

doctorposter2Like the South Korean recruitment company that decided an appropriate response to issues of workplace stress was to require employees to stage their own funerals, complete with writing farewell letters to loved ones, climbing into coffins and having them closed by a guy in black who is supposed to represent the Angel of Death, and then spending a few moments lying in the darkness of a closed casket.

South Korea has the highest suicide rate in the industrialized world, and workers in Seoul and other parts of the country have ongoing problems with workplace pressure.  The problems are the byproduct of the hyper-competitive, achievement-oriented South Korean society and traditional approaches to workplace culture that motivate employees to get to work earlier, and leave work later, than the boss.

So how in the heck does staging mock funerals help with stress and suicide?  It’s supposed to help the employees value life and get them to reflect on its meaning.  The president of the recruitment company explained that the company had not really been successful in getting employees to change their “old ways of thinking,” and he thought “going inside a coffin would be such a shocking experience it would completely reset their minds for a completely fresh start in their attitudes.”

Would it, really?  Or would it, instead, drive home to the workers forced to crawl into a casket that their employers have a ridiculous amount of power over their employees’ lives, to the point where they can force the employees to stage macabre and disturbing stunts just because the company president thinks it’s a great idea to do so?

Suddenly the hassles with Phil in accounting and the power games played by the assistant vice president for corporate planning don’t seem all that bad.