 Having discussed stress and especially the gas model, the general adaptation model, today we are going to talk about a concept called burnout. Now, as you can see that burnout was you know construct, which was basically coined, this term was coined in 1970. So, historically if you look at it compared to the other type of constructs in psychology is it is not so old. And what it actually represents is a state of emotional exhaustion with diminished sense of personal accomplishment. So, primarily if you are experiencing burnout, what you are actually experiencing is a state of no exertion, where you feel that you are completely, completely, completely emotionally exhausted. And this has also to know associated with the concept that you know have not achieved what you actually aspire to. So, there the sense of accomplishment will always be low that is 1, 2 that this is basically a state, where you do not have a short term emotional exhaustion rather you have a long term emotional exhaustion. So, you feel that you are emotionally exhausted, but that is for a long, long time. There is also a reduction in the interest that gets reflected in terms of the failure of the individual to use defense either at the personal front or at the work front. So, it could be something of personal nature, it could be something that has to do with the work front, but then the person is not able to use the defenses. These defenses we have know exhaustively gone through in the past. So, here you realize there we had discussed that no human beings by default have the capability of using one or the other defense in order to safeguard their ego structure. So, the integrity of the ego is never put at stake because the defenses are operational, but here what happens one realizes that the person shows greater degree of inability in terms of utilizing those defenses. And you feel that you are working too much, you are overworked, but then also the fact that you are undervalued. So, now the moment you read this you basically sense that it has largely to do with work place. So, burnout is a construct which basically represents an interaction of a human being at the work place with the situation there and then experiencing this type of a state of emotional exhaustion. So, burnout will always be associated with work place. Now, if you try to understand the distinction, what is the distinction between stress and burnout? In the case of a stress one still shows no over engagement in the situation whereas in the case of burnout one completely shows disengagement that is the major thing and to the stress of state also includes certain degree of hyper activity whereas in the case of burnout one shows finally the extreme sense of hopelessness. So, these are the two important determinants which establishes the distinction between stress and burnout. Now, what could be the causes of burnout? Because it has to do with work therefore work related issues such as lack of or losing control over the task. So, either you do not have sufficient control over whatever you are supposed to do or you realize that initially you had a greater command over the situation but over a period of time you have started losing it. It is further associated with the fact that if I am losing control of the situation that means that others might get the credit of whatever happens at the work place. So, even though I have put my head I have put my effort I still do not get the credit for doing whatever is accomplished whatever is achieved at the work front and third the work environment full of expectations and pressure and you realize that the place where you are working it is full of demands full of pressure and basically you realize that the situation that you are in it demands more and more from you and up to a certain time you keep on trying to maintain that level but then gradually you feel you are completely exhausted. Remember one thing pressure at work place expectations at work place these are normal expectation at the work front. No company is going to hire you saying that we have no expectation whatever you do is with us. The company we put forth an expectation in front of you. We usually have feeling that usually in the government sector probably there is no such expectation or no such pressure but there are several professions where you would realize that there is there are tremendous pressure and I should rather tell you that many of the decorated jobs which otherwise feels no you feel that it is really a very decorated job where you keep on giving commands to other. In reality if you look at their work front you would realize that they are into much more pressure. Say for example you take the district magistrate of any place and you realize oh great very celebrated and that is the reason why there are many many aspirants of the civil services. But if you actually realize what happens at their work front you realize oh they are under tremendous pressure. There are extreme degree of expectations from you both something which are positively oriented things that you should not do are hence negatively oriented but people expect you to do it. So basically what I am trying to say is that any work front will demand certain things from you. You would certainly be put forth with a target you would be supposed to achieve it. So expectations might vary at the work front but absence of expectation you cannot think of it. And similarly pressure you will certainly have it. It could be you know little higher at times there it could be little lower at times but it is not that you will not have pressure at all. And therefore what we had discussed in the past that it is primarily your ability how do you interpret the situation wherever you feel you use your know different forms of defenses. In case you realize that you know there are still certain you know problems at hand you can still you know try to go for certain strategies that can help you minimize it or handle it properly but you can still manage it. And therefore it is not that all those know work somewhere certainly become you know say a victim of burnout that is not true. Just like stress we are once again coming to burnout we are trying to look at the physical and the behavioral indicators. Physical indicators you usually feel that you are know completely tired and drained. I do not know if you have seen there was a very old advertisement of a health drink. Sinkara have you seen this hand? Javajafri know is just like this it is like a know lump of cloth that if you leave it free it will collapse on the ground. So, he is in that state and there is a background narration which says know that a bichara kam ke bojkamara sko chaiye the name of the brand comes kasingkara know and he takes know one teaspoon of sinkara and suddenly you know there is a full of energy and starts dancing in the at the work workplace and so forth. So, mostly you feel that you are completely tired know you are drained of energy very frequently you have to apply for medical leaves you become ill. You have frequent headaches and back sex headaches and back sex you remember in the stress also this was there. Change in the food habit change in the food habit we also discussed as part of a stress where either you under it or over it and change in the sleep habit this is also over wrapping with a stress symptom behavioral indicators you withdraw from your responsibilities. So, certain responsibilities that you are assigned to at the work front you start withdrawing from them omitting work taking longer time to do things you prefer to remain mostly in isolation and you reflect frustrations on others. So, these are know the physical and the behavioral indicators that you are probably now becoming susceptible to burn out or you have developed it in the full blown shape. Now, there are know basically 12 phases of burn out that has been discussed what is important is that these phases need not follow a sequence it is not at first stage 1 then stage 2 then stage 3 it could be a randomly know one can come to these stages the stages are compulsion to prove. So, you somewhere within feel a strong urge that I have been given this task and I will certainly prove my word that yes I am the only one in the office who can do this nobody else hard work you have you put more and more effort neglecting needs remember that this is only at the work front. So, there would be several other needs that you will have to know achieve. So, you start certain you start neglecting certain needs just last week we had guest speaker who was talking about know different types of addictions and there he mentioned about addiction to work what is popularly referred to as work colleagues. So, he was referring to some of the business tycoons who happen to be his client because he is a practicing psychiatrist know at Bangalore. So, he said that know there are certain business tycoons who happens to be his client and phases of their life where they would invest excessive time at the work front and they would be know busy doing certain things for their profession at the cost of many things including a case where he said that the child was suffering from meningitis and the father still continued working in the office did not take the child to the hospital. His over engagement with the work came to the extent where the wife decided that let us be separated, but then these were the people who later on know change the whole face of software industry in India. So, these are interesting things know burnout basically says that it is a state where you have multiple needs and you are developing you are reflecting your inability to strike balance between various types of needs. If your child is suffering from meningitis it is your responsibility to take her to the hospital and of course, it is your responsibility to work in your office and know meet things their deadlines, but then if you compromise one because of the other that is the trick know that all of us have to play and that is basically a skill know how you certain things that you under do at time certain things that you over do at sometime, but in the phase of burnout one constantly reflects this tendency of neglecting certain needs. Displacement of conflicts so usually when you confront the conflicting situation you have a tendency to displace it. So, displacement would be something like say I have a confrontation with her and in turn I reflect that conflict in my relationship with him. So, the actual source of conflict is displaced over to the relationship with somebody else revision of values you start revisiting your own value system something which is extremely difficult know you remember we had talked about the frame of reference we had talked about the value assumptions and know values it is not easy to change the belief value system that you are now completely end out with, but then in this case you start know relooking at it relooking does not mean that it will undergo a change, but still you will revisit it. Denial of emerging problems the problems that are now sprouting out you show you might show a tendency of overlooking them start to showing withdrawal symptoms obvious behavioral changes changes very very apparent for others, but you do not find out those changes in yourself. Depersonalization so you have a tendency to know dissociate things and make them depersonalized inner emptiness you feel as if you are completely within you are completely empty tendency of developing depression and finally the full blown symptom of burnout the symptoms that we had seen right now in the previous slide. So, it has been suggested that burnout will you know follow these 12 phases the only difference is that unlike many other types of illnesses where you have the full protocol here you will achieve these 12 stages, but it could be know that it might not follow exactly the sequence in which it has been presented here. Largely it might follow in at times you will find that it follows and then suddenly something else comes first. So, these are basically the phases of burnout having discussed you know stress and burnout we would now come to perhaps an interesting thing I thought that I must certainly discuss it basically it is the self help tips there is a long list of what one should do basically the recommended strategies for handling stress and burnout, but most of them are supposed to be done under a supervision. So, if you have a supervisor to look what exactly you are doing then only you should practice those things and therefore, I am putting here things where you do not need you know supervisor for example, say yogic meditation for example, transcendental meditation for example. Now, they are supposed to really help you a lot in terms of handling your stress and burnout, but then you cannot know start closing your eyes and that is I am in transcendental meditation or yoga is not only know adopting a particular posture it also has to do with breathing regulation and hence it requires supervision. So, this list has things which actually does not need any supervision one eat right and exercise eat right basically means that you should have pattern of consumption of food means say approximately fixed timings fixed is not so rigidly defined say for example, if 8 o clock if you have your breakfast then you can pre-pwn it or postpone it by half an hour or so, but then ensure that your breakfast time remains the same if your lunch time is 1 o clock ensure that your lunch time remains the same. Problem comes when you have a variable eating habit sometimes you skip breakfast sometime you have it at 6 o clock sometime you have it at 11 o clock your dinner time also know varies right from 8 o clock to 3 o clock 3 a m in the morning. So, such type of things should not be done maintain a time frame for eating 2 usually this is true for the dinner timings know that it is always good not to have know spicy food in dinner not to have highly food in the dinner because it is interrupts with your sleep cycle you might feel you know drinking water more if you feel drinking water more then you have more than need to go to the toilet and this all this disturbs your sleep cycle. So, that is the reason behind that and do some type of an exercise it could be anything if you are interested in aerobics do aerobics simple walk then go for a walk if you hate walking and but you will enjoy playing then play whatever you do but know physically you should certainly put yourself under some type of an exercise. This helps a lot in fact I am not going into the scientific details of it, but you remember we had talked about the biochemical regulation of stress and it has been observed that if you practice the first step the biochemical regulation gets starts getting affected. So, finally what you achieve is much more than what you actually apparently get involved in besides know eating habits and regular exercises it is also important to know maintain certain sleep pattern. Sleep pattern maintaining sleep pattern simply means that again just like food have a consistent pattern. So, if you go to the bed at 9 o clock in the night then every night you should go to the bed at 9 if you have a guest and therefore it has been postponed by half an hour or one hour that is fine. But it is not that know whenever I feel sleepy I will go and sleep and whenever I feel waking up I will wake up you would realize that such people know very early in their life become insomnia. Insomnia is basically the state of sleeplessness and many people you would find know that initially started with the fact that know I am working and whenever I will feel sleepy I will sleep you would realize that they are the people who I know for first few days will sleep late in late in the night may be 2 o clock, 3 o clock it would be early in the morning and after 4 or 5 days suddenly after right from 6 o clock they will start feeling dizzy there is no beauty in having that type of a random sleep cycle there is always know it is good to maintain a consistent pattern. In fact know you would realize that people whom maintain consistency in their sleep cycle will tell you that last night even though he or she had gone late to the bed the wake up time was the same. So, even if you delay one part of it the second part know it becomes systematic and these are the people who do not need any alarm to wake them up. So, they will wake up first and switch off the alarm and you can compare them with people who would put the alarm sleep the alarm goes on stop it or put it in the snooze mode and again sleep and alarm does not serve any purpose for them maintaining eating proper eating habits maintaining regular exercises maintaining your sleep cycle it really know affects the biochemical regulation of the stress mechanism like anything. Importantly community involvement is also supposed to help you a lot community involvement would basically mean that you get involved in walk where others are involved. So, it is not your individual involvement in an enterprise rather it is a group which is instrumental doing it. Say for example, I will take a larger example of from the society and then come to a smaller subset of it which has to do with your current state. Say if the society engages itself in organizing some festival and a group of students or a group of member from the society they are involved in collecting the donation organizing everything participating in the whole process these are considered to be great stress busters because the whole thing that it is my target and I have to achieve it you know you personalized everything to the greatest extent. Those things are not involved and hence the sense of achievement is far more the apprehension of failure is much less and overall because it is an involvement of a group of individuals. Therefore, overall you even get a chance to show your interpersonal skills also while interacting with the group. So, community involvement has always been considered to be the best stress buster. People who are involved in certain type of religious activities for example, that also is considered to be good mechanism of handling stress. So, you show certain degree of commitment every day you go to the place of worship you surrender yourself to the god and that also is a very interesting stress buster you release yourself all your pent up feelings gets released and you hold the god responsible for all the sufferings that you have. Poor god cannot respond back that no I am not responsible for it you had credited this course all bad grades the discredit goes to you or the instructor I am not a party, but because god does not have this freedom to say. So, to somebody who is showing extreme degree of commitment you in turn experience great degree of solace and you would realize that people who have been into such practices for long usually their stress level is far lower compared to people who are not involved into it. I am not recommending that you should worship one god or you should go for one type of prayer that I am not recommending all I am saying is that this is basically a state where you show certain degree of commitment to somebody who is beyond your own self. So, when you surrender yourself to the god to a deity it works as a stress buster. Similarly, when you involve in community activities you do not take pride in accomplishing the task rather you surrender yourself with the group goal. And therefore, whether you go into something like as individualized as prayer and religious commitment the benefit that you get here is equivalent to the benefit that you get out of getting involved in community tasks. So, it helps like anything in fact there are interesting studies showing that people who walk for larger causes in their life they are usually not disturbed by the usual stressors that otherwise adversely affects normal human being does not fight for bigger causes. For example, say I am an individual who is just involved into his professional activities his household responsibilities and that is it. Compare me with somebody who is fighting for the independence of the country much larger cause and you would realize that if you take a top 10 stress induces all those 10 would know very seriously and adversely affect me and most of them will not at all matter for the person who is fighting a much bigger cause. So, that is also an interesting thing. So, when you start getting involved in community activities usually the target that you have is usually of a higher order and therefore, the fact that no success and failure can adversely affect you that is not going to happen for such type of things. An interesting thing is what is called as self hypnosis. Hypnosis I am sure you must be aware of what hypnosis is. Now, in hypnosis primarily what happens is that you are made to go to a trans state by an expert who gives you certain instructions. Have you seen an actual hypnotic session? Do not give me reference of movies. They are not actual hypnotic sessions that you see there. Usually you have very cinematic representations of hypnotic sessions in the movies. Somebody who would do like this, somebody who would move a locket like this, all villain type of creatures. But in the clinical setup if you see, very interestingly the client is made to lie down on a comfortable bed or a couch and then the psychotherapist would sit there, give some instructions and that is it. No locket, no such movement of the fingers and even not that villain type of an appearance. Here you have a well dressed psychotherapist sitting in a clinic. Now, in hypnotic sessions you are given suggestions. You follow them and your compliance to the instructions given by the psychotherapist makes you reach a trans state. In the trans state you are asked certain things. Either the therapist would seek certain information from you or the psychotherapist asks you to perform some task. For example, I will give you a session that I have seen myself. May be 13, 14, 15 year old girl who had the problem of convulsion, hysteric convulsions. She was made to lie down on the bed. Here was an elderly psychotherapist who gave her an instruction that you will now have that convulsion and she had that thing, but that on a safe place. So, it was a bed where she was asked to have that convulsive attack and then she was given the instruction that now you are going to regain your consciousness. In hypnotic sessions there is something called post hypnotic instruction. Post hypnotic instruction basically is an instruction that you give to the client before he or she is made to regain her consciousness, but this instruction that you give is supposed to be complied to after he or she has gained the consciousness. So, just before she was made to regain her consciousness she was told that you will not be able to speak till you have a glass of water and she was made to regain her consciousness and she kept on having this tendency to clear her throat till she was given a glass of water and then she could speak and talk to us. The primary benefit of post hypnotic instruction in such case would be you ask the client that now you will not have a convulsive attack till I ask you to have it. This means that once you regain your consciousness at any other place which could otherwise be very dangerous for you, you would not have the convulsive attack and then you will be told that fine come again back to me after 15 days. Again after 15 days I make you lie down comfortably and I tell you that fine now you will have the convulsive attack and gradually this duration the buffer period will be gradually become more and more longer. Self-hypnosis is a similar type of state, but with a change that you do not have an instructor telling you that these are the commands that you have to follow. You, there is also a word called auto-suggestion. You keep on constantly suggesting your own self and you comply to those suggestions that is the state of self-hypnosis. Perhaps initially when you listen to it, it seems difficult that one can achieve that state, but if you try out it works and with practice you can really achieve that state that I will not do something unless I instruct myself to do it. So, that is self-hypnosis and that is a state, a little later we will associate it with something else also. That is a state where you decide that you will not get over-indulged in something which in turn becomes a source of stress or burnout for you. Another important thing also is that you can develop certain special interests. So, if you are interested in sports, maximize your interest, literature, music, dance, drama, anything everything that you are interested in invest more time and energy into that and that brings me to an interesting issue, I think you can give me your feedback. Usually students who participate in such type of activities, club activities for example, you have dramatics club, you have music club, you have film club, different different clubs and students who are more and more involved into club activities, usually their grades are also relatively better compared to students who will refrain from participating in anything because he or she has to study. One second dimension in terms of placement, students who have this versatility usually they get placed first and usually their overall accomplishment in terms of placement indicators is also relatively better compared to if you have only and only been into studies, is that if it is not true you can tell me, second one is true, the first one is not true, you do not think so, first one is not true, I would still know say that the first one, see compare a situation, I am x and you are y, x continuously only studies and does nothing else, gets an A, y studies but is also interested into say something like sports and has invested sufficient time into being into the field and participating in inter IIT sports and athletic competition, has lost certain games, has won certain games, got cups at times, got medals at time, got prizes at times and finally, had to get a B. Now, in absolute terms if you only look at A and B and which is better you say that of course, there is a big difference between these two according to you, according to me there is not much of a difference, but that is no I think student and instructors perspective, when you say 9, 9, 9, 8, B is still 8 and A is 10. So, 8 and 10 how can you say that it is 1 and the same now, but in terms of most of the activities of your life which actually helps you manage many, many spheres, you would realize that your involvement in multiple tasks is still better compared to when you know have invested yourself in unilaterally into one direction and you have achieved only and only in that direction. I will give you many examples, many examples, last week when we had that guest speaker we had you know several rounds of you know parties where mostly it was the doctors who joined the group, because the guest speaker happened to be from that profession and I could very easily you know sense the difference between different types of medical practitioners there, medical practitioner who joined the parties somewhere around 11, 45 in the night, both the couples say coming and saying that we were we are just close the clinic to come for the party. And somebody who says 6 o clock I had closed everything and 8 o clock I am here see, how you manage things is a skill, all I am trying to say is that if you have certain special interests, it is still you know it is not the correct word to use, but still it helps you not to get completely corrupted by the unilateral type of activity that you are involved in. And therefore, managing a stress know when you have multiple sources of interest that is still better and it serves you better compared to when you have only unilateral things to do. Then there is an interesting thing that has to do with vacations, if you can afford to go on vacation affordance means financially you should be able to afford it, also you should be able to know have that much time with you, quite possible that you do not have know the liberty to enjoy leave for 4 long days. And therefore, you cannot go for a vacation, then there is a word called mini vacations know that I will have just few hours and that is the vacation that I will enjoy. Remember that especially Europeans they usually give discredit to the Indians that we do not know how to enjoy vacations are work and vacation is mixed. So, even though it is a weekend what I call as a weekend I will check my mail, I will draft something, I will do something make my slide now it is half the vacation is work. There are several countries if you have interacted with people on some other side of the globe you would realize that in certain in certain places vacation and weekend is weekend know. So, if Saturday Sunday happens to weekend it is weekend know you do not even check your mail you do not receive any official phone call nothing. So, end of the week is really an end here end of the week is something like know either clearing of the pending job or to prepare for the coming week. So, we are given this discredit there is also interesting concept in psychology what is called as mind vacations know mind vacation is something like you lie down comfortably close your eyes and imagine as if you have visited a place say for example, you could not know manage to go to Covalent because your office did not give vacation to you or because of other other constraints, but say if you can close your eyes and visualize yourself on the beach at Covalent and you can hear the sound of the sea waves if you can hear the know if you can feel the pleasant feelings that you usually would have had if you would have had gone to that place that is know called mind vacation. There is an interesting technique here in psychology it is used in clinics it is called Soznegrad technique there what happens you have a room which is very deemily lit know so minimal light in the room you are made to go there and lie down and then they will play a music and the music is exactly this thing know. So, but before introducing you to such technique the therapist would have certainly talked to you and identified what is something that you like the best say for example, you see that I am fascinated to visiting a seashore then I know what tape to play you say that now forest know where you see birds and in this case know you have tapes which has know very fantastic audio know chirping of the birds for example, all types of birds and beautiful records know. So, you the therapist will just ask you to lie down relax your body close your eyes and will play that tape and my experience is at max 10 minutes and most of the people who come to the clinic would later on sleep because you are made to lie down on bed on the floor. So, you lie down listen close your eyes listen to such music for 10 minutes and you fall asleep. So, that is the reason why mind vacation is also considered to be a very very effective technique. In fact, at places now know very very limited places where you have know oxygen clinics if I do not know if you have heard this word. If you are in the urban area where everything is very congested and you feel very bad you have insufficient supply of pure oxygen in the air. Now, you have oxygen clinics. So, you just go there you are made to stand in a chamber where you have the real oxygen you breathe in inhale and then after some time you come out of course, you have to pay for the service. Similarly, here also if you are going on a mind vacation in that setup there also you have to pay for it, but then you can have it. The most economical thing would be that you can just lie down in the hostel on your bed run the fan and constantly look at it and look at the movement of the fan. You can blink, but then your rate of blink is slower. So, you gaze at blink and then gaze at it. You would realize now that it really clears off certain things from your mind. Now, the important ones identify goals and work toward them. So, finally, you have to identify what are you trying to achieve. This would also basically mean that once you have certain set of goals you are having the ability to prioritize them what to do first. Say, if I have left my bed little late today and then therefore, I cannot come to the 8 to 9 lecture what should I do? Should I have breakfast first or lecture first? I am not saying which is important. All I am saying is that in life you will have many such things. All that you need to do is to prioritize that this is at most important. This is important. This is also important. This is little bit important. This is likewise if you prioritize and accordingly if you know try to achieve something and compromise on achieving certain thing it is fine. It might look philosophical, but the truth is that what is extremely important today after certain time if you would revisit your own experience of those days. In many cases you would feel it was silly for me to think it was important. I had given so much of importance to that. So, retrospectively when you know visit your own life experience and reflect upon it many things usually does not appear as important as you thought of it at that point of time. Important thing incorporate humor in life difficult, but usually most of us tend to be extremely serious and if you smile also then there are plastic smiles. You know how many millimeters this to move and that to move, but if you remember when we were talking about the damage repair mechanisms we had talked about laughing it off. Now, laughing it off is not only the very fact that you are laughing at the event, but it also means that you are able to see things in a much broader perspective and you know how unimportant or fuzzy this whole construct of importance is given around this type of circumstance. So, people who are otherwise know very humorous in nature they are very less susceptible to these things and even if they become stressed they are very easily able to manage it. And that is the reason you would realize that people who are of know members of dramatics type of a thing they are much easier it is much easier for them to manage such type of a situations rather than those who are into hardcore 3 to 9 laps type of a setup. And biofeedback of course is not something that you can do it on your own, but I deliberately added something in the self help tip I have been talking about it repeated times that now there are mechanisms to show you usually how your entire body system is functioning. So, something that we had studied as part of the autonomic nervous system saying that now these things we do not have a voluntary control over them. Now, you have technology available to usually show you how these involuntary tasks are being performed. And biofeedback is a technique where sensors are attached to your body you are in a whatever state you are. And then you can see how your bodily functions actually functions whether it is in a hyper state in a hyper state and then you are told at see you know this is how it should have been the standard template. And then you just look at the screen and you instruct yourself come down come down come down come down just like self hypnosis part of it you give suggestion to yourself you look at it and you would realize that within few minutes there are changes know. And if you keep on keep on practicing it for little duration periodic sessions you would realize that you gradually develop that tendency to have control over yourself. And therefore, all the physical changes that we had talked about with respect to both stress and burnout you are able to manage good part of it. So, when it says know that heart beat increases pulse rate increases breathing increases perspiration increases GSR increases. And you say oh come on I have seen all of this many a times no I am well trained. So, I will tell my heart slow down here there is no point no beating faster and I will have a control over it. Because, I can control X therefore, all X 1 X 2 X 3 the practice which are dependent on this I will also have certain degree of control over it. So, this is these are the interesting techniques I thought before we know close the chapter on stress and burnout because it was heavily loaded with problems and symptoms and nothing more. Therefore, I thought we will end up with this tomorrow when we meet we will be starting with another construct what is called as post traumatic stress.