How to talk about chronic stress and burnout and help someone who is in denial?

A key concern expressed by people on the topic of chronic stress and burnout is how to talk to colleagues or associates who are showing signs of chronic stress/ burn out but don't seem to recognise the symptoms themselves. This paper aims to review in more details the possible approaches.

Denial is one of the symptoms of burnout. It's a resistance to change. At some level, we know that something needs to change in our life, we cannot continue in the same old ways but we are not yet ready to accept it. There is no magic bullet to help someone get out of denial. However the following steps can guide you.

1. Develop a safe relationship

The person is stressed because s/he feels threatened and the threat is experienced as almost permanent, which keeps the sympathetic nervous system (the ‘alert’ system) active all the time. Creating a feeling of safety is essential to allow the person to relax enough to address the issues.

How to create safety? Build rapport

show empathy: demonstrate you can understand how the other person feels and can see things from their point of view. Try to keep your attention undivided during the conversation. When our attention is split, we tune out a bit, missing crucial details especially the emotional ones.
be genuine: visual and verbal behaviours should be working together to enhance communication. Show you care.
Non verbal rapport building: It’s like getting in tune with the other person. It happens naturally if you are really paying attention to them. We coordinate most strongly via subtle non-verbal channels like the pace and timing of a conversation and our body movements.

2. Share your concerns, help people recognise the symptoms

a. Inform

Share facts about stress. Discuss the benefits of acting early on chronic stress. The longer the chronic stress lasts, the longer it will take to recover.
Make the conversation less personal and threatening by using an 'intermediate' such as a stress and burnout test or MBTI grip model.
Making burnout socially acceptable is a big step towards enabling conversations . If an organisation is blind to the existence of burnout it is harder for an individual to acknowledge what is happening.

b. Offer feedback

People will go a long way to hide their symptoms, so be a very careful observer and show them that you see them. For most people, there is a secret hope that someone will see their suffering.
Give feedback using the SBIO model (Situation, Behaviour, Impact, Options). Be clear on the changes you have observed in their behaviours, the impact it has on you. When the person is ready, look at the possible solutions/ options.
If performance has started to suffer because of chronic stress, share that information too while reassuring that you don't question their competences, only their ability to use their competences because of chronic stress. This must be done in a very caring way, having built strong rapport with the person. Start looking at solutions when they are ready. You may have to challenge the idea that working harder is an option for them.
If you have build trust in your team, use the team dynamic to give feedback and offer support. Empathy and care are elements of emotional resilience.

c. Engage emotionally

Ask the person to talk about their fears regarding chronic stress and burnout. Becoming aware of fears and beliefs around burnout can help the person realise that they are in denial. Share your own fear and beliefs, share your own experience if relevant : making yourself vulnerable can help the other to open up. Suggest they talk to people who have experienced chronic stress and burnout.

Burnout is often called the grief of honor. People prone to burnout are often highly motivated, engaged, committed, ambitious and with a deep sense of responsibility. Remind them that they have these qualities (if true) and they are now experiencing the dark side of these qualities. There is often a lot of shame connected with a sense of failure. And shame silences people. Reassure the person that s/he is highly valued and recognised . They might not be able to hear it immediately but it might be essential in dealing with their fears when they reflect.

3. Consider involving external expertise

Sometimes people will feel more comfortable to talk to someone who is not connected to work. They will feel safer about the potential consequences of their sharing. There is no conflict of interest with an external third party.

They might also trust more and give more value to the feedback of a person who is perceived as competent in the field of stress and helping people, such as a coach or a therapist . Remember that trust is built up of 3 components: competence, integrity and empathy.

Hearing a similar feedback from different sources can help a person get out of denial and start taking actions to reduce chronic stress.

Who to involve?

Work with someone who has experience in the field of chronic stress and burnout. Check also that there is a real 'fit' between your colleague and the third party. If after the first meeting, your colleague doesn't feel the 'click', offer other options.

Here are some brief notes about the kind of help that is available and what each can offer.

NB: not all countries recognise burnout as an illness.

Psychologist: their main task is to diagnose the burnout and explain to people the different phases of burnout and recovery. They can assess how long a person needs to stay out of work. Many psychologists are also trained as psycho-therapists.
Psycho-therapist: they will help go deep in understanding the causes of the burnout, the patterns that caused the burnout. The in-depth awareness will help people start changing from the inside. A psycho-therapist is usually less action oriented with regards of the 'going back to work' phase.
Doctor: they can also diagnose burnout and more and more practices offer s
upport to recover from burnout. In some countries, the doctor employed by the company is key in the process of diagnosing burnout as an illness and decide about sick leave.
Coach: usually seen as the lowest threshold to consult. They understand the business world and can empathise easily with what people are going through. Coaches can help create awareness, acceptance and understanding about the burnout causes, the patterns that led to burnout, help build (and adjust ) a plan for self care and recovery, rebuild self esteem and help face the required changes, hold people accountable for the follow through. This is usually done in alignment with the line manager to ensure success. Coaches are often involved in the recovery phase. But they can also be effective in the earlier stages of burnout.