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The most common model for explaining the burnout syndrome is the concept of the imbalance between requirements and resources, ERI by Johannes Siegrist: here the requirements are listed on one side of the scale and the resources on the other. In most cases it becomes very clear how large the imbalance between the two profiles is.


Twelve Phases of the Burnout Syndrome after H. Freudenberger and G. North

  • Urged to prove something to himself and others.
  • Extreme striving for performance to meet particularly high expectations.
  • Overwork with neglect of other personal needs and social contacts.
  • Transferring or passing over inner problems and conflicts.
  • Doubts about one's own value system and formerly important things like hobbies and friends.
  • Denial of emerging problems, increasing intolerance and contempt for others.
  • Withdrawal and avoidance of social contacts to a minimum.
  • Obvious behavioural changes, progressive feeling of worthlessness, increasing anxiety.
  • Depersonalisation through loss of contact with oneself and others, life is increasingly "mechanistic".
  • Inner emptiness and desperate attempts to mask these feelings through overreactions (sexuality, eating habits, alcohol and drugs).
  • Depression with symptoms of indifference, hopelessness, exhaustion and lack of perspective.
  • First thoughts of suicide as a way out of this situation, acute danger of mental and physical collapse.


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Physiologically burnout is a stress pathology and the lost balance and the associated inability to regulate is reflected in it. The healthy stress reaction makes fight or flight reactions possible: As soon as the brain perceives something as stress, it puts the organism in a state of readiness to react. The vegetative nervous system, especially the sympathetic nervous system, is activated via the so-called hypothalamus-pituitary adrenal cortex axis (HHNA) and cortisol is released into the body. Pulse and breathing rate are accelerated, the muscles are better supplied with blood, fat and sugar reserves go into the blood. Processes that are not urgently needed at present are inhibited, such as digestion and immune defence. This process becomes problematic when it becomes chronic, i.e. when the body is chronically put under stress - this can be accompanied by deregulation of the entire HHNA axis and thus by insufficient regulation between tension and relaxation.

It is assumed that permanent stress in some people first leads to an increase in cortisol levels, but then to a lower reactivity on this stress axis due to overloading of the corresponding receptors. In fact, burnout has a large overlap in its symptoms with disorders for which deregulation of the HHNA axis has already been demonstrated, such as functional somatic syndromes (e.g. chronic fatigue syndrome, fibromyalgia), affective disorders, e.g. depression, and trauma, among others. Burnout is associated with work-related stressors, but not only: the development of the disorder is preceded by many factors, internal, external and physical stressors.
(N. Fonberg)


The exhaustion spiral:

And where do you find yourself on this spiral?


What traditional Chinese medicine has to say about burnout

When the kidney chi (prenatal reserve energy) is used up, only one thing helps: do nothing, rest, gather strength and slowly rebuild energy, omit everything resilient like electrosmog, cigarettes, alcohol, coffee for a while, eat warm food …

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