I just came across the following on Norman Lebrecht’s very busy and popular ‘Slipped Disc’ arts blog. I took the trouble of translating the article, originally in German, for your benefit. Here is the news…
In Germany, more and more musicians are suffering burnout!
I went to the trouble of translating the article from NMZ…
If music makes you sick
Under the burn-out syndrome suffer more and more musicians and music educators
In high-performance professions complain increasingly be “burnt out”.”Burn-out” is symptomatic of a society and time in which the performance of spiral rotates faster and faster. Even the music professions are covered by this development.While there is no scientific statistics but the local and regional associations of the German Association of Musicians are increasingly aware of this problem. The magazine “Music School internally” about this as a separate issue. The chairman of the Munich Tonkünstlerverband, Edmund guardian, invited members to the meeting, a psychiatrist and psychotherapist Dr. Jürgen Brunner, who explained in his presentation of this phenomenon from a scientific perspective. Since burnout is an important issue for musicians, this presentation is made available to a wider public in the nmz here…
In high-performance professions complain increasingly be “burnt out”. “Burn-out” is symptomatic of a society and time in which the performance of spiral rotates faster and faster. Even the music professions are covered by this development. While there is no scientific statistics but the local and regional associations of the German Association of Musicians are increasingly aware of this problem. The magazine “Music School internally” about this as a separate issue. The chairman of the Munich Tonkünstlerverband, Edmund guardian, invited members to the meeting, a psychiatrist and psychotherapist Dr. Jürgen Brunner, who explained in his presentation of this phenomenon from a scientific perspective. Since burnout is an important issue for musicians, this presentation is made available to a wider public in the nmz here.
Burn-out from a medical perspective
Reports of burn-out take in the press and on television, a broad space. Because of burn-out are quite a few sick leave. Burnout has a negative impact not only on those directly affected, but also on the social environment. Burned-out teachers are demotivated and feel a high degree of aversion to their students.Physicians with burnout make more medical errors. Conversely, the burn-out risk increases with the incidence of treatment failure. Reliable data on burned musicians or music teachers are not available currently.
spite of the health economic significance of the phenomenon still exists no standard definition of burnout syndrome. Burn-out was in the 2013 updated psychiatric classification system DSM -V not received the American Psychiatric Association. In the current international classification ( ICD -10) is burn-out only as an additional diagnosis under the category Z73 (problems in coping with life) listed. Under Z73.0 one finds burnout, burnout or state of total exhaustion. At the current state of research burnout should not be used as a diagnostic for reasons of incapacity or retirement. The scientific psychiatry has dealt with burnout little. This is due to the definitional uncertainty and the lack of validation of the burn-out concept. In addition, there is overlap with established and better researched psychiatric diagnoses such as depression.
burnout is considered as a precursor or risk factor for depression. Some psychiatrists see in a fuzzy fashion burn-out diagnosis and an unfinished concept. There is a danger of trivializing when burnout is diagnosed, even though there is already a depression. Burn-out is less stigmatizing than the depression diagnosis. Burn-out is marketed as illness of the initial engagement with idealism and enthusiasm combined. Finally, one must have burned for something to burn. In contrast to burnout are well evaluated for depression before and evidence-based treatment approaches and treatment guideline.While mild and moderate depression through psychotherapy alone can be treated well and sustainably (especially through behavior therapy), a combination of psychotherapy with antidepressants recommended for severe depression. If depression overlooked and dismissed as burn-out, this can lead to incorrect treatment decisions. This creates the risk of chronicity, which worsens the prognosis.
Symptoms of burnout
Burn-out is understood by proponents of the concept as a work-related syndrome that is characterized by three core symptoms: (1) emotional exhaustion, (2) a callous, indifferent or cynical attitude towards clients, customers or colleagues, and (3) a negative assessment of the personal performance. Also experience sleep disturbances and so-called psychosomatic symptoms such as diffuse pain without organic findings, functional cardiovascular and gastrointestinal complaints as well as an altered eating habits. In the end it comes to depression, helplessness, despair, and to feelings of meaninglessness and hopelessness.
, the development of burnout can be described as a phase-like process: initially an exaggerated ambition is present. Affected show increased commitment to goals. There is a compulsion to prove himself. This leads to emotional and physical exhaustion due to the ongoing professional commitments. As a consequence, their own needs are neglected. Sufferers hardly take time for non-professional needs.Hobbies and social activities are neglected, with the aim to conserve the remaining resources for professional needs. The sense of one’s own person is lost (depersonalization). This leads to a flattening of the emotional, social and spiritual life. Motivation, creativity and productivity take off. Consequences are reduced commitment for others and for the work. It develops a distanced attitude towards fellow human beings. The apathetic attitude can be increased up to a debased cynical attitude towards pupils, students, clients, employees, colleagues, relatives and friends. The feelings towards others are flattened. In interpersonal contacts, the emotional involvement is lost. Leisure and social activities are considered useful and useless. The function of social withdrawal and cynical attitude is to establish distance from other people in order to reduce the emotional overload.
Through the training time burden and the associated emotional exhaustion confidence in their own professional capacity is lost. Sufferers are dissatisfied with their own performance skills. As the profession of real life content and the central source of self-worth is, it tries to compensate for the lack of performance by excessive work. Alcohol or drugs can be used to enhance their own performance or to distract themselves and come to rest. There is the risk of substance abuse. Developing an addiction is possible. In the end, social withdrawal, neglect lead by our own needs and the lack of positive experiences an increasing amplifier loss. There is strong feelings of inner emptiness and lack of interest. Life is increasingly perceived as meaningless. This can build up to a so-called psychosomatic reactions and despair.
Causes of burnout
The term burnout was first used in 1974 by the psychoanalyst Herbert J. Freudenberger. He was referring to the “burning” of staff in mental health professions. In recent decades, a remarkable shape change is stated: The classic burnout of the 1970s and 1980s were idealists in psychosocial helpers professions (psychologists, doctors, nurses, social workers) who have failed to unrealistically high altruistic objectives. The burn-out of today is attributed to inhuman working conditions and loads in a globalized capitalist society. The causes of today’s burnouts strong working pressure and strong competition and lack of achievement are usually considered. Today, not only psychosocial helpers professions are affected, but many different professional groups and family carers.
prerequisite for the development of burnout is the interplay of personality inherent and environmental factors. The extremes of a continuum representing the active and passive burn-out. On the one hand there is the “Selbstverbrenner” who fail at their inflated idealistic expectations of themselves (active burn-out). At the other extreme are the “victims of circumstances” that are worn down by external overwork (passive burn-out).
Among the predisposing personality-related factors include high idealistic expectations of themselves, excessive ambition, perfectionism, and a strong need for recognition. At risk are people who want to make it right and others always like to suppress their own needs.
Susceptible to burn-out are people who can not delegate or want because they think they are irreplaceable. Such people tend to be hard work and commitment through to overconfidence and excessive demands. For it is the work of the only reasonable replacement for giving employment and social life. Another risk factor is low self-esteem. People without strong social ties are at an increased risk of suffering from burn-out.
Typical external condition factors are occupational situations that are characterized by high demands and low influence. On the one hand, high job demands, time pressure, increasing responsibilities and workload play a role. At the same time there is little autonomy and low participation.
Due to lack of achievement, inadequate ventilation and wages and lack of social support, there is an effort-reward imbalance. Particularly toxic is a bad working environment to bullying.
Poor communication among themselves, poor teamwork and conflict between individual fighters, problematic institutional rules and structures, administrative constraints and a lack of fairness and value conflicts are important spawning conditions.
Important differential diagnosis: depression
Burn-out is a risk factor or precursor of depression. It is important to know whether there is already a depression. By no means a depression should be minimized as burn-out, as this can lead to incorrect treatment decisions, which restricts the forecast. Depression can become chronic. Main symptoms of depression include depressed mood, loss of interest or joy or reduced drive or increased fatigability. At least two of the main symptoms must be met.
, the diagnostic criteria for a major depressive episode are fulfilled, when present in addition at least two of the following additional symptoms: loss of self-confidence or self-esteem, unjustified self-reproach, or strong, inappropriate guilt, recurrent thoughts of death or suicide or suicidal behavior, complaints about or evidence of diminished ability to concentrate or think, indecisiveness or indecisiveness, psychomotor agitation or inhibition, sleep disturbance, loss of appetite or increased appetite with corresponding weight change.
Duration of symptoms must be at least 14 days. Depending on the number of different symptoms to a mild, moderate or severe severity.
Treatment and Prevention
The therapy aims to change the cognitive-emotional schemas of the person and the creation of favorable working conditions. The treatment is based on severity. For lighter expression of measures to change habits and to optimize the work-life balance are recommended. This are three important factors: relief of stress, relaxation and recreation through sport and disillusionment in terms of adoption of perfectionist expectations. If the burn-out syndrome more pronounced or is already a depression before, psychotherapeutic interventions and antidepressants are (optimally combined with psychotherapy) into consideration.
In more severe cases, the consultation of a licensed psychological or a medical psychotherapist (preferably an integrative working behavior therapists strongly recommended) or a psychiatrist.
, the treatment costs are completely taken when indicated by statutory and private health insurance and aid in general. With a psychotherapist obligation exploratory meetings are possible, which are paid by the fund. This requires no medical referral.
psychotherapeutic interventions mostly at a school disciplinary approach is recommended, which should focus on cognitive-behavioral methods. The aim of psychotherapy is to restructure dysfunctional schemas such as perfectionism or a distorted significance of the work. Importance of establishing an independent work of self-esteem and promote positive experiences.
relaxation techniques are used to reduce internal tension. Regular physical activities are used to reduce stress and improve sleep. Important is the establishment of sustainable and satisfying social contacts.
Also of importance is the improvement of unfavorable coping strategies, including substance abuse, social withdrawal, avoidance, escape, self-pity, resignation and thoughts circles belong.
was the first choice for the prevention of burn-out syndrome are supervision groups viewed that should be moderated by an external psychotherapists. Pure colleague groups without external supervision, however, have no preventive and prophylactic effect.
Dr. Jürgen Brunner is a specialist in psychiatry and psychotherapy, teaching supervisor and therapist (Bavarian Chamber of Physicians).
More at www.brunner-psychotherapie.de