Burnout for Pilots, Air crew and all connected with the Airline Industry
We live in stressful times. The media appears preoccupied with tales of recession and its effects on industries including the airline industry, professions and businesses both large and small. The talk within the Airline industry is one of doom and gloom; soaring fuel prices giving rise to cost cutting measures; airline closures and recession resulting in less people flying. With all this negative talk, airline staff become more stressed with added pressure from above and added responsibility for meeting deadlines and avoiding costly delays. When the situation changes, the push is on for growth, making up for lost ground; the same pressures, impossible deadlines; anti-social flying schedules; early starts and late finishes. The flying profession is a high stress industry without the added pressures that worldwide recession brings. If we are not careful we start to use alcohol or even drugs, prescribed or otherwise, excessively in order to cope. There is the danger of a breakdown or Burnout. But what is Burnout?
Burnout is a psychological term for the experience of long-term exhaustion and diminished interest. Burnout is not a recognised disorder in the American diagnostic manual for mental illness (DSM-IV) although it is recognised in the WHO version (ICD-10) where it is labelled as "Problems related to life-management difficulty". Many healthcare professionals often use the term “stress induced depression” and prescribe an anti-depressant medication which is not an ideal solution for those whose work relies on strict rules about the use of medication. The diagnosis of “depression” is also not always fully understood by Management - who often react adversely.
The term burnout in psychology was coined by Herbert Freudenberger in his 1974 Staff burnout. He and his colleague Gail North theorised that the burnout process can be divided into 12 phases, which are not necessarily followed sequentially:
- A compulsion to prove oneself
- Working harder
- Neglecting one's own needs
- Displacement of conflicts (the person does not realise the root cause of the distress)
- Revision of values (friends or hobbies are completely dismissed)
- Denial of emerging problems (cynicism and aggression become apparent)
- Withdrawal (reducing social contacts to a minimum, becoming walled off; alcohol or other substance abuse may occur)
- Behavioural changes become obvious to others
- Depersonalisation (life becomes a series of mechanical functions)
- Inner emptiness
- Burnout syndrome
Maslach and her colleague Jackson first identified "Burnout" in the 1970s and defined the antithesis of burnout as engagement. Engagement is characterised by energy, involvement and efficacy, the opposites of exhaustion, cynicism and inefficacy.
They developed a measure that weighs the effects of emotional exhaustion and reduced sense of personal accomplishment. The Maslach Burnout Inventory has become the standard tool for measuring Burnout in research on the syndrome and uses a three dimensional description of exhaustion, cynicism and inefficacy.
Many theories of Burnout include negative outcomes including job function (performance, output, etc.), health related outcomes (increases in stress hormones, coronary heart disease, circulatory issues) and mental health problems (depression, etc.).
Other studies aboard Cruise ships introduced the term Organisational Burnout as "a general wearing out or alienation from the pressures of work". Understanding Burnout to be personal and private is problematic when it functions as part of an organisational issue caused by long hours, little down time and continual peer, customer and superior surveillance".
How the stress is processed determines how much stress is felt and how close the person is to Burnout. One individual can experience few stressors, but be unable to process the stress well and thus experience Burnout. Another person, however, can experience a significant amount of stressors, but process each well and avoid Burnout. How close a person is to a state of Burnout can be determined through various tests.
We all have stress in our lives; it helps drive us forward, keeps us on our toes and helps us meet our aims/objectives. It is when we allow it to become too much, that the problems start.
Burnout is the result of physical and mental exhaustion brought on by working too long hours, for too long, under too much pressure. When the fuse in our head blows and the lights go out it is too late and only a period of rest and recuperation with therapeutic help will get us back on our feet again. The secret is to recognise the symptoms and seek help before the fuse blows. Don’t overload the circuit!
To some degree the Airline Industry is protected by regulations to stop overworking but a disruptive shift pattern, Management pressure to keep to schedules and cut costs, the fear of redundancy and the general doom and gloom that prevails in these times, can disrupt sleep and add unwanted worry to an already stressful job. Alternatively in the good times there is the same Management pressure to keep to schedules and cut costs, additional requests for pushing the boundaries of the legal restriction on flying hours to the minimum. For more senior Captains, there is the additional pressure of endless ‘supervision’ flights watching over new recruits as they take the controls. They are no longer able to relax knowing the flight is in the capable hands of an experienced Senior First Officer and thus find themselves having to be alert throughout.
It is important to recognise that stress or Burnout can affect all of us in the working environment. It is not the private domain of the highly successful Directors of multi-nationals. All of us who are conscientious workers, demanding of self with high expectations of self and others and a perfectionist streak are susceptible to Burnout. Pilots and Aircrew along with those responsible for keeping the public safe when they fly fall into this category. Recognising it is another matter.
There are many symptoms of Burnout. Some are easier to identify, others are more hidden. In order to identify the symptoms it is often vital that you listen to others and not ignore what you may hear as criticism. It is also essential you listen to yourself – listen to what your body and your head are telling you. Don’t ignore it. Your performance may decline as you become more tired (you work longer hours to achieve the same output); you become more irritable in the workplace or at home; your sleep becomes disrupted; your enjoyment of life outside or work decreases and relationships start to suffer. Tiredness leads to exhaustion and with it physical health problems (high blood pressure, headaches, ulcers, heart attacks) and maybe mental health problems (Clinical depression).
Often because of the strict rules about health issues and flying, Aircrew do not report the way they are feeling to their Management for fear of being grounded. In a recent BALPA report seen by the Clinical Team at Nova Vida Recovery Centre it was shown that in a recent survey carried out by University College London over a 6 month period that 75% of pilots did not file a fatigue form when they felt they should have done.
There is an unfortunate tendency to start to self-medicate at any stage along the road to Burnout. Alcohol is the ‘medication’ chosen by most but in today’s world other drugs such as cocaine are taking an ever increasing role in helping us to cope. Both alcohol and cocaine are addictive and although we may start by having a couple of drinks to help us unwind or to get to sleep, the addictive nature of the drug is such that you need more and more of the substance to achieve the same effect. Before you know where you are, addiction has set in and your job performance suffers even more. This rapidly increasing downward spiral has inevitable consequences; you lose your job, your business/career or your family or all three. If you have managed to avoid excessive use of alcohol or drugs there is a strong possibility that Clinical Depression will result. Clinical Depression is not an illness of the weak – they don’t get overly stressed. It is an illness of the strong. And watch the coffee consumption; it often rises in periods of excessive stress. It has a reputation for keeping you awake but it also keeps you from sleeping and recharging the batteries. It can cause headaches, irritability and it increases your blood pressure. In very large quantities, coffee has an addictive quality and for some classic withdrawal symptoms – increased anxiety, slight hand tremor and the craving for the ‘drug’. Cigarette consumption also increases in times of stress. The dangers of this are well known and well publicised.
Most pilots keep religiously to the rules about drinking alcohol before flying. Most are proud of the fact they never drink alcohol 24 hours before arriving for duty. This is to be commended but it can also mask a serious drinking problem. Binge drinkers become accustomed to periods without using alcohol but in those periods off-duty, the consumption is well above the recommended limit (21 units for men and 14 units for women, per week). The problem with binge drinking is that the binges become heavier and longer and the gaps in between become shorter. Taking one final drink just inside the ‘bottle to throttle’ recommended abstinence period can lead to devastating effects. Additional stress, difficulty sleeping or problems with Management can often lead to that one drink too many.
If you can identify the build up to Burnout, it may be you will be able to apply self-help techniques and avoid the need to see a Doctor or Therapist and avoid the need to be grounded from flying. Cut back on alcohol, caffeine and cigarettes or cut them out completely. Alcohol, drugs, cigarettes and caffeine have a negative effect on sleep. Either they affect the quality of sleep or they stop you from sleeping. Sleep is essential to rebuild and to regroup after a stressful day. Take a break – a weekend away can be very beneficial and the job will still be there when you get back. Take some regular but not necessarily strenuous exercise – 30 minutes a day two or three times a week. If the gym isn’t your scene, try just simple walking. It’s great exercise. Many of these activities are available when you’re flying involves stop-overs in distant lands. Most hotels have gyms and pools and in most countries of the world a short walk is a possibility. If you can find ways to relax such as Reflexology, Mindfulness, Yoga, Tai Chi, Meditation or just taking the dog for a walk. But most important of all and probably one of more difficult changes you may have to make is recognising that there are so many aspects of your life you cannot change, recognise what you can change and change it and accept the things you cannot change and move on.
While individuals can cope with the symptoms of Burnout, the only way to truly prevent Burnout is through a combination of organisational change and education for the individual. Organisations address these issues through their own management development, but often they engage external consultants to assist them in establishing new policies and practices supporting a healthier work life. Maslach and Leiter postulated that Burnout occurs when there is a disconnection between the Organisation and the individual with regard to what they called the six areas of work life: workload, control, reward, community, fairness, and values. Resolving these discrepancies requires integrated action on the part of both the individual and the Organisation. A better connection on workload means assuring adequate resources to meet demands as well as work/life balances that encourage employees to revitalise their energy. A better connection on values means clear organisational values to which employees can feel committed. A better connection on community means supportive leadership and relationships with colleagues rather than discord.
DStress and Burn Out need to be taken seriously. If you are in any doubt you should consult your Doctor or a qualified Therapist. Don’t put if off. Burnout is not a sign of weakness and recognising it is a sign of strength. Doing something about it is a sign of taking responsibility. As a Manager or Captain you also have a duty of care to your staff. Recognising the symptoms in them and getting them help can save you long periods of staff absence, expensive litigation and money.
This article has been written by the Clinical Team at Nova Vida Recovery Centre, Algarve, Portugal who have years of experience helping members of the Airline Industry. Initial assessments by telephone or in person in the UK are free and all enquiries are treated in the strictest confidence.
CONTACT INFONova Vida Recovery Centre