Burnout Therapy
Psychological therapy for burnout, chronic stress and feeling overwhelmed
Psychological therapy for burnout, chronic stress and feeling overwhelmed
Burnout can develop gradually.
You might initially notice that you are working longer, finding it harder to switch off or needing more effort to do things that previously felt manageable.
Over time, you may begin to feel exhausted, detached, irritable or increasingly unable to cope with demands that you would once have handled without difficulty.
Sometimes the confusing part is that you are still functioning.
You may still be going to work, meeting deadlines, caring for other people and appearing capable from the outside.
Internally, however, it can feel as though you are running on empty.
I am Dr Aaron Shaw, Chartered Clinical Psychologist, and I offer evidence-informed psychological therapy for adults experiencing burnout, chronic stress and related difficulties.
Therapy can help us understand not only what has exhausted you, but also the psychological patterns that may have made it difficult to recognise your limits or respond to them.
When it feels like you have nothing left to give
Burnout does not usually happen because somebody suddenly becomes unable to cope.
More often, it develops after a prolonged period of coping with too much.
You may have spent months or even years managing pressure, solving problems, taking responsibility and pushing yourself to keep going.
Eventually, the strategies that helped you manage may stop being sustainable.
You might notice that you:
-
feel physically or mentally exhausted
-
wake up tired even after sleeping
-
struggle to concentrate or make decisions
-
have become less motivated at work
-
feel increasingly detached or cynical
-
find yourself becoming irritable more easily
-
struggle to switch off after work
-
continue thinking about work during evenings, weekends or holidays
-
feel guilty when you are not being productive
-
dread tasks that previously felt manageable
-
procrastinate because everything feels overwhelming
-
make mistakes you would not normally make
-
find yourself withdrawing from colleagues, friends or family
-
feel less patient with the people around you
-
stop enjoying things outside work
-
feel that you are constantly falling behind
-
keep pushing yourself despite knowing that you are exhausted
Sometimes people describe reaching a point where they simply think:
I can't keep doing this.
That does not necessarily mean you are incapable of doing your job or managing your responsibilities.
It may mean that the way you have been managing them is no longer sustainable.
What is burnout?
Burnout is a term used to describe a pattern of exhaustion and disengagement associated with prolonged stress and demands.
It is particularly associated with the workplace, although people often use the word more broadly when describing exhaustion linked with caring responsibilities, studying or sustained periods of pressure.
Burnout is not simply being tired after a difficult week.
It tends to develop when there has been a persistent imbalance between what is being demanded from you and the opportunities you have to recover.
You may begin by responding to pressure by working harder.
You stay later.
You prepare more.
You check things again.
You take on additional responsibility.
You sacrifice breaks.
You work during your evenings.
You tell yourself that things will settle down once you get through the next deadline.
For a while, these strategies can work.
The difficulty comes when the next deadline is followed by another one.
And another.
Eventually, your mind and body may begin signalling that something needs to change.
Burnout is not a personal failure
One of the most damaging interpretations of burnout is:
“I should be able to cope with this.”
People experiencing burnout often compare their current performance with how they used to function.
Tasks feel harder.
Concentration becomes more difficult.
Motivation decreases.
You are not achieving as much.
You may therefore conclude that the problem is you.
But burnout usually makes more sense when we look at the interaction between the demands placed upon you, the environment you are working within and the expectations you place upon yourself.
Therapy can help us explore all three.
The aim is not to teach you to tolerate an unlimited amount of stress.
Sometimes the environment genuinely needs to change.
At other times, there may also be patterns around perfectionism, responsibility, boundaries or self-worth that make it particularly difficult to protect yourself from excessive demands.
Often, both are important.
Why does burnout develop?
There is rarely one single cause.
Burnout can emerge from a combination of external pressures and internal patterns.
Prolonged demands
High workloads, insufficient resources, staffing pressures, difficult working relationships, uncertainty, organisational change or repeatedly having more work than can realistically be completed can gradually erode wellbeing.
Short periods of pressure may be manageable.
Problems are more likely to arise when there is very little opportunity for genuine recovery.
Difficulty switching off
Sometimes work ends physically but continues psychologically.
You might leave the workplace but spend the evening thinking about what needs doing tomorrow.
You check emails.
You replay conversations.
You worry about something you might have forgotten.
Even during periods that technically count as rest, your brain remains at work.
Perfectionism
Perfectionism can make demanding environments even more demanding.
You might believe that work needs to be completed to an exceptionally high standard, find mistakes difficult to tolerate or spend significantly more time on tasks than other people would consider necessary.
High standards can be an enormous strength.
They become costly when anything less than perfect starts feeling like failure.
Read: Why Am I Such a Perfectionist?
Over-responsibility
Some people find it extremely difficult to leave problems unresolved.
If something needs doing, you do it.
If somebody needs help, you help them.
If the team is struggling, you take on more.
The ability to take responsibility may be one of the qualities that has helped you progress professionally.
But without boundaries, responsibility can gradually become over-responsibility.
Difficulty saying no
You may intellectually recognise that your workload is too high while finding it extremely difficult to refuse another request.
Thoughts might include:
They'll think I'm difficult.
Everyone else is busy too.
It'll be quicker if I just do it.
I don't want to let anyone down.
I should be able to manage.
Each individual decision may seem small.
Collectively, however, they can leave very little capacity remaining.
Self-worth becoming connected to productivity
For some people, achievement is not simply something they value.
It becomes part of how they measure whether they are doing well as a person.
Rest can then feel uncomfortable.
Doing nothing can feel wasteful.
A quiet day can create guilt rather than relief.
And slowing down may feel strangely threatening.
When productivity becomes connected to self-worth, the natural response to struggling is often to work harder.
Unfortunately, that can accelerate burnout.
Why can high-achieving people be particularly vulnerable?
Burnout does not only affect people who dislike their jobs.
In fact, people can become burned out doing work they care deeply about.
You may be:
-
conscientious
-
ambitious
-
compassionate
-
highly responsible
-
dependable
-
motivated
-
perfectionistic
-
accustomed to coping
-
someone other people rely upon
These qualities can be genuine strengths.
But strengths can become vulnerabilities when they are used without limits.
Being dependable can become never asking for help.
Being conscientious can become never feeling that something is finished.
Being ambitious can become never allowing yourself to stop.
Caring about other people can become continually putting their needs before your own.
Psychological therapy does not need to remove the qualities that make you good at what you do.
The challenge is learning how to use those qualities without allowing them to consume all of your available resources.
Burnout and the difficulty of resting
A common reaction to burnout is:
“I just need some time off.”
Sometimes rest is exactly what is needed.
But people can become frustrated when they take a weekend away or have some annual leave and still do not feel restored.
There are several reasons this can happen.
You may technically stop working while continuing to think about work.
You may spend your time off worrying about everything waiting for you when you return.
Or you may find that being unproductive creates guilt, restlessness or the sense that you should be doing something.
This is why recovery from burnout is not always simply about doing less.
Sometimes we also need to understand why stopping has become so difficult.
Burnout and stress are not quite the same thing
Stress often involves feeling that there is too much happening.
Too much work.
Too many demands.
Too much responsibility.
Too much to think about.
You may feel activated, worried and pressured.
Burnout can develop when this continues for too long.
Instead of feeling increasingly activated, you may eventually begin feeling depleted.
Motivation decreases.
You become detached.
Things you once cared about may begin to feel pointless.
You may go from thinking:
“How am I going to get all of this done?”
to:
“I don't care anymore.”
That shift can be particularly worrying for people who have always cared deeply about their work.
Burnout or depression?
Burnout and depression can sometimes look very similar.
Both may involve:
-
exhaustion
-
reduced motivation
-
difficulty concentrating
-
withdrawal
-
disrupted sleep
-
irritability
-
reduced enjoyment
-
feeling unable to cope
There are also important differences.
Burnout is usually closely connected with prolonged occupational stress and demands.
Depression can affect how someone feels across many different areas of life, even where work is not the main difficulty.
However, the distinction is not always straightforward.
Someone may initially become burned out and subsequently develop depression or anxiety.
Equally, someone experiencing depression may initially interpret their difficulties as work-related burnout.
You do not need to work out the correct label yourself.
Psychological assessment allows us to consider the wider picture and understand what may be contributing to how you feel.
Read: Burnout vs Depression – How Can You Tell the Difference?
Why burnout can become a cycle
When people become exhausted, their capacity naturally decreases.
Unfortunately, many people respond to this reduction in capacity by becoming harder on themselves.
Imagine that you would normally complete ten tasks in a day.
You are exhausted and manage six.
Rather than recognising that you are depleted, your mind says:
“You're falling behind.”
So you work later.
You skip the gym.
You cancel plans.
You eat at your desk.
You use the evening to catch up.
Tomorrow, you begin with even less energy.
Perhaps you manage five tasks.
Now the self-criticism becomes louder.
So you push harder again.
This can create a cycle:
High demands → exhaustion → reduced capacity → self-criticism → pushing harder → less recovery → greater exhaustion
One of the aims of therapy is to understand your particular version of this cycle and identify where it can begin to change.
How can psychological therapy help with burnout?
Therapy for burnout should involve more than simply telling you to practise self-care.
You may already know that sleep, exercise, breaks and boundaries would probably help.
The more useful question is:
What gets in the way of actually doing those things?
Psychological therapy can help us understand:
-
what contributed to burnout developing
-
the demands currently placed upon you
-
what happens when you try to slow down
-
your beliefs about work, success and productivity
-
perfectionistic expectations
-
difficulty delegating
-
responsibility for other people
-
patterns of people-pleasing
-
fear of disappointing others
-
self-criticism
-
difficulty setting boundaries
-
how you respond to mistakes
-
whether your identity has become overly connected with work
-
what genuinely helps you recover
-
what may need to change in your environment
From there, we can begin identifying changes that are realistic and sustainable.
What happens in burnout therapy?
First, we understand how you reached this point
Burnout usually develops over time.
We can explore what has been happening in your work and wider life, how demands have changed and what strategies you have used to cope.
Often, this helps people recognise that burnout did not appear from nowhere.
There has been a process leading up to it.
We develop a shared understanding
Clinical psychologists often refer to this as a psychological formulation.
A formulation allows us to bring together the different factors contributing to what you are experiencing.
For example, your formulation might involve:
external pressures
combined with
high personal standards
combined with
difficulty saying no
combined with
feeling responsible for other people
combined with
very little opportunity for recovery.
This provides us with a much more useful question than:
“How do we make you more resilient?”
Instead, we can ask:
“What needs to change for this to become sustainable?”
We identify practical changes
Depending on your circumstances, this might involve working on:
-
boundaries
-
workload
-
prioritisation
-
perfectionism
-
delegation
-
assertiveness
-
recovery
-
switching off from work
-
responding differently to self-critical thoughts
-
reconnecting with relationships and activities outside work
Often, change involves small experiments rather than dramatic decisions.
We work with the patterns underneath
For some people, burnout exposes longer-standing psychological patterns.
Perhaps you have always needed to achieve.
Perhaps saying no has always felt uncomfortable.
Perhaps being needed by other people has become an important part of your identity.
Perhaps rest has always felt like something that needs to be earned.
Therapy gives us an opportunity to understand where these patterns came from and consider whether they are still serving you.
We think about preventing burnout from returning
Feeling better is important.
But if you return to exactly the same patterns and circumstances that created burnout, the difficulty can gradually reappear.
An important part of therapy is therefore identifying early warning signs and developing a more sustainable way of managing demands in the future.
My approach to burnout therapy
My approach is integrative and formulation-led.
That means we do not begin with the assumption that everyone experiencing burnout needs the same set of techniques.
Instead, we develop an understanding of your particular difficulties and identify the psychological approaches most likely to be useful.
Depending on your needs, therapy may draw upon approaches including:
-
Cognitive Behavioural Therapy (CBT)
-
compassion-focused approaches
-
mindfulness and acceptance-based approaches
-
work focused on perfectionism and self-criticism
-
assertiveness and boundary-setting
-
emotional regulation strategies
-
behavioural approaches to rebuilding activity and recovery
-
psychological approaches for understanding longer-standing beliefs and patterns
The aim is not simply to help you tolerate more pressure.
It is to help you develop a way of working and living that is psychologically sustainable.
Why work with a Clinical Psychologist?
Clinical Psychologists undertake extensive doctoral-level training in psychological assessment, formulation and psychological therapy.
Rather than working from one therapeutic model alone, Clinical Psychologists are trained to draw upon different evidence-based psychological approaches according to the needs of the individual.
This can be particularly useful with burnout because the presenting problem is rarely just:
“I have too much work.”
Workload may be an important part of the picture, but there may also be anxiety, perfectionism, self-criticism, low mood, relationship pressures or long-standing beliefs about achievement and responsibility.
My role is to understand that wider psychological picture and work with you to develop an approach that makes sense for your circumstances.
You do not need to wait until you completely burn out
One of the difficulties with burnout is that people who are accustomed to coping can become extremely good at continuing.
You may tell yourself:
I'll get through this busy period.
Things will calm down soon.
Other people have more on than I do.
I'm probably just tired.
Sometimes people only seek support once they reach the point where continuing has become extremely difficult.
You do not have to wait until then.
It may be worth seeking support if you recognise that:
-
work is increasingly consuming your life
-
you rarely feel properly switched off
-
your motivation is disappearing
-
you have become more irritable or detached
-
your standards are becoming impossible to maintain
-
you are continually exhausted
-
work is affecting your relationships or wellbeing
-
rest no longer seems to restore you
-
you know something needs to change but do not know where to start
An initial conversation can help us consider what is happening and whether psychological therapy might be useful.
Burnout therapy face-to-face and online
I offer individual psychological therapy for adults experiencing burnout, chronic stress and related difficulties.
Face-to-face appointments are available on weekday evenings in Bristol and on Saturdays in Cheltenham. Online appointments are also available across the UK.
Online appointments can be particularly useful for people trying to fit therapy around demanding professional or working lives, with some evening appointments also available.
If you are looking specifically for face-to-face support, you can visit my local therapy pages for further information about appointments in your area.
Using private health insurance
I am recognised by a number of private medical insurers, including AXA Health, WPA and Vitality.
Whether psychological therapy relating to burnout or work-related stress is covered will depend upon your individual policy and the difficulties for which treatment has been authorised.
If you are hoping to use private health insurance, it is therefore important to confirm your cover with your insurer before treatment begins.
I have created a separate guide explaining how private health insurance appointments work and what information you may need before booking.
Related burnout resources
What Are the Signs of Burnout?
Burnout can build gradually, which means the early signs are not always easy to recognise.
This guide explores some of the emotional, psychological and behavioural changes that can occur when prolonged stress begins taking its toll.
Burnout vs Depression: How Can You Tell the Difference?
Burnout and depression can both involve exhaustion, loss of motivation and withdrawal.
This guide explores where they overlap and some of the important differences.
Why Am I Such a Perfectionist?
High standards can help us achieve a great deal.
But when mistakes become unacceptable or nothing ever feels good enough, perfectionism can come at a significant psychological cost.
Frequently Asked Questions
Is burnout a mental health diagnosis?
Burnout is not itself a formal mental health diagnosis.
The term is generally used to describe exhaustion and disengagement associated with prolonged stress, particularly in relation to work.
However, burnout can occur alongside difficulties such as anxiety or depression.
Psychological assessment can help us develop a clearer understanding of what you are experiencing rather than relying on a label alone.
How do I know whether I am burned out or just stressed?
Stress and burnout can overlap.
Stress often involves feeling overwhelmed, pressured and as though there is too much to manage.
With burnout, people may increasingly experience exhaustion, reduced motivation and detachment from work that they previously cared about.
There is not always a clear dividing line between the two.
You do not need to decide which term describes you before seeking support.
Is burnout the same as depression?
No, although they can look similar and can occur together.
Burnout is usually closely associated with prolonged work-related demands, whereas depression can affect mood, motivation and enjoyment across many areas of life.
If it is unclear which is contributing to how you feel, this can be explored during psychological assessment.
Do I need to leave my job if I am burned out?
Not necessarily.
For some people, significant changes to their working situation may ultimately be appropriate.
For others, changes in workload, boundaries, expectations, working patterns or the way they respond to demands can make a substantial difference.
Therapy is not about telling you whether to stay in or leave a particular job.
It provides an opportunity to understand what is happening and make considered decisions about what needs to change.
Can therapy help if my workplace is actually the problem?
Yes, but therapy should not pretend that every workplace problem can be solved by changing the individual.
Sometimes workloads are genuinely unreasonable, environments are unhealthy or there are organisational problems that need addressing.
Therapy can help you think clearly about what is within your control, develop boundaries and coping strategies, and consider what changes may be needed.
It should not simply teach you to tolerate an unsustainable situation.
How many sessions will I need?
There is no fixed number of sessions that is right for everyone.
For some people, burnout is relatively recent and connected with a specific period of pressure.
For others, it is connected with longer-standing patterns around perfectionism, responsibility, self-worth or boundaries.
We can discuss this during assessment and review progress together throughout therapy.
Can burnout therapy take place online?
Yes.
Online psychological therapy can work particularly well for people balancing therapy with demanding working lives and allows me to work with adults throughout the UK.
Whether online or face-to-face appointments would suit you better can be discussed during an initial consultation.
Can I use private health insurance?
I am currently recognised by AXA Health, WPA and Vitality.
Whether your insurer will fund treatment will depend on your individual policy and the reason for which psychological therapy has been authorised.
You should therefore confirm your cover and obtain any necessary authorisation before treatment begins.
Thinking about getting support for burnout?
You do not need to wait until you reach the point where you can no longer cope.
And you do not need to know exactly what needs to change before getting in touch.
A free 15-minute consultation gives us an opportunity to briefly discuss what you have been experiencing, answer any initial questions and consider whether arranging a full psychological assessment would be a helpful next step.
If you are looking for burnout or stress therapy, you can view support options in your area or get in touch to arrange an initial consultation.