Interview with Claude de Scorraille published in ÇA M'INTERESSE SANTÉ (Fall 2017)

This evil of the time has become the symbol of suffering at work. Claude de Scorraille, psychotherapist, proposes to approach it not as a pathology of the individual but as a disorder of the relationship between this individual and society.

I'm interested Health: What exactly is bu rn-out?

Claude de Scorraille : The term is due to Herbert Freudenberger, a psychoanalyst who dealt with drug addicts in New York in the 1970s. His patients said they were "consumed" by flames, leaving an immense void inside. He resumed this image when he in turn went through a big depression. He then qualified his state of burn-out, which he himself translated into French as “internal burn”. We speak today rather of "burnout syndrome", which mainly affects jobs that require personal investment, with heavy workloads. The characteristics of the contemporary era have obviously accentuated the risk, with communication technologies that erase the boundary between work and private life, but also with the imperative of results, of performance.

Is there a profile that predisposes to it?
These are often people who are too cut off from themselves, anesthetized in their feelings and therefore more easily in denial. We find profiles of people who are ultra-organized, ultra-committed, very attached to the profession, to the company.

You analyze the process as a triple relationship problem: with oneself, with others and with the world...
Well-being is a feeling, a sensation, there is something very subjective in that. This feeling of harmony, of balance, is due to the way we adapt to a multitude of factors: for example, a heavier workload, the arrival of new technology, new colleagues, strained relations with customers, but also their body, their emotions, whether or not they feel like they can count on themselves. At some point, this balance can become dysfunctional, costly to maintain.

In fact, do we exhaust ourselves in a headlong rush?
When a difficulty, uncertainties arise, everything depends on how we will manage the discomfort or the fear that arises, because fear is the feeling that dominates in this process. Fear of disappointing, fear of failure... Some people will implement an avoidance strategy. Or the perfectionists - who are good candidates for burnout - will want to control everything to anticipate the problem. This is what we call solution attempts.

Cannot these attempted solutions be effective?
It is their excess that becomes harmful. For example, we avoid saying "no", we take charge of a job that we consider badly executed by another, we make ourselves ultra-available... In the immediate future, we derive satisfaction from our action because that she walks. Suddenly, we enter this headlong rush of which we are not aware and which blurs the relationship to the difficulty. Avoidance, for example, brings out the belief that we were right because we would have been unable to cope... At the end of this logic of always more action, we can come to the conclusion that you can't do it anymore, you're at the end of your physical and mental resources.

Does that mean you have to fall to get out?
This moment of collapse, called burn-out, is in fact the culmination of the process and not necessarily its end. It is for us a "window of opportunity", a key moment for the person to accept an offer of help. This is when people in crisis can be accompanied. From there, a metamorphosis becomes possible. It will consist in defining differently their way of considering themselves, their relations with others and with their work.To do this, we do not hesitate to seek the involvement of all those concerned: attending physician, occupational physician, the resources human resources and those occupying management positions.

Can those around you help to become aware of the problem?
It's very difficult because the person is trapped in a logic of denial. Those around you can see that she is going straight into the wall, either because she isolates herself at home, dwelling on her problems and becoming less available, or, if she is outgoing, because she talks about them a lot. But when we tell him to let go, not to stress so much, even if the person can agree on the level of reason, in fact he will not be able to pick up because in his eyes it would be much too risky.

And after a vacation, how not to fall back into an infernal cycle?
On vacation, we should have relaxed. But if, as soon as you get back, you start anticipating too heavy tasks, if you have nightmares, if you feel worried, it's time to say to yourself: "What worries me, and how do I tend to deal with that?" It is interesting to ask the question of what is the most painful and to see how we can modify it. You can go and consult the occupational physician, but also your hierarchy to try to put something specific into a diffuse feeling. One can also wonder what small change would make the work more qualitative. Because in general the world of work is above all that of the quantitative: the quantity of things that one does or of things that should no longer be done. It's a very rational approach, but what's at issue is the relationship to the work situation, which is very qualitative and emotional. This is why some live a situation correctly while others come out of it completely bloodless.

There is much debate about the advisability of recognizing burnout as an occupational disease.
Are you for? No, because we believe that this recognition would result in making the necessary metamorphosis much more difficult. We will establish a responsibility of the context - even if we do not say that the work situation does not play a role - while accentuating the victimization, considering that the victim of burnout is unsuitable and victim of mistreatment. Whereas the issue is not in terms of who is wrong or who is right. It is the association of the situation at work (disproportionate workloads, chaos linked to a change of organization) and the rigidities of the individual which are in question. Not everyone in the same environment burns out.

Interview by Philippe Bordes.

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