One of my patients, let’s call him Johan, came to my office complaining of burnout, although “complaining” is perhaps too lively a word for what I saw. With the mild embarrassment of a man returning a defective piece of equipment, he simply said, “Something in me no longer works.”

Burnout, we are told, spans many domains. Emotionally, the person feels drained, cynical or just plain numb. But this numbness is cruel, because it masquerades as relief. “Finally”, the exhausted self thinks, “I don’t care anymore.” 

Physically, there’s also a fatigue that sleep won’t fix. We tend to think of tiredness as a debt that rest will repay. In the case of burnout, however, eight hours become nine, nine become eleven, and still the person wakes feeling already spent.

Cognitively, the person can’t concentrate. Making small choices like what to eat, whether to reply someone and which task to start becomes an ordeal. The mind, once capable of holding many threads, finds itself confused by a single strand. 

Beyond exhaustion

Burnout is exhaustion compounded by betrayal. People have given years to a role or an institution. They have gone beyond their limits because the stakes seemed far too serious to step away from. Their very sense of identity depended on it. But over time, what was commitment began to feel like extraction.

Something in these people has been overused. Their competence became a reason to give them more to do. And when they finally began to falter, the failure was framed as a personal weakness.

That is why burnout can feel so morally disorienting. More than tired, these people may feel foolish for having cared so much, or angry for having trusted a system that now rejects them. Most commonly, they are ashamed that they are no longer able to perform. 

That is also why ordinary rest may not be enough. Such breach of trust needs thorough repairs. 

Advice for friends and colleagues

As a psychoanalyst and executive coach, I routinely attend to people like Johan who feel that life has become meaningless. While I strongly believe that professional help should be sought in such cases, I wrote this article to give pointers to the managers, colleagues, relatives and friends of the Johans of this world. (If you are a helping professional, I have published a more comprehensive article on Medium.)

Upon finding that someone is in the throes of despair, the temptation, even for well-meaning helping professionals, is to argue: “But you have so much to live for. Think of your family. You just need a break.” These phrases are not necessarily false, but they address despair as if it were a mistaken opinion. To tell Johan that life is worth living is like telling a starving man that restaurants exist. While it is true, it is spiritually useless.

Resist the urge to correct the person’s despair and instead show an interest in it. I’m not talking about agreeing with what they say. Simply listen to them. I cannot overstate the importance of being willing to sit with the despair – even the silence – and not immediately try to shoo it away.

This goes double if you are the person’s manager. Don’t say: “Let’s get you back to full productivity” or “Have you considered a seminar on work-life balance?” That may be exactly the kind of advice that made Johan ill in the first place. Burnout and obedience are often entwined. The person may be living under the rule of an internal tyrant created long ago by a demanding father, a needy mother or a despotic teacher who rewarded compliance. What they need is to break free from a certain mindset.

Addressing suicidal ideation

After you’ve listened and resisted arguing or giving “helpful” advice, never hesitate to ask directly, in plain language, about any suicidal ideation: Have you thought about killing yourself? Do you have access to the means? Have you ever tried before? 

There is a common fear that such questions would reinforce ideation and that asking is, in some sense, suggesting it. The evidence, however, does not support this notion. These questions open a window in a room already filled with gas. They make it possible to breathe.

Another key question to ask is, “What has kept you here so far?” Where appropriate and possible, involve people the person trusts. You may discover who this trusted entourage is by asking: “Does anyone else know you are feeling this way?”

What is worth trying

If your questions uncover significant suicidal risk, respond immediately by involving emergency services, crisis intervention or hospitalisation depending on the situation. Access to lethal means must be cut off. But once these life-and-death concerns are out of the way, what could be the next steps aside from counselling?

1. Start with practicalities 

Don’t worry at first about rescuing the person’s soul. Take care of the body: sleep, food, movement, daylight, medical evaluation and the reduction of intoxicants. This sounds insultingly simple, but the psyche is embedded in flesh, and flesh has non-negotiable demands. A person who has slept four hours a night for six months needs solid REM sleep and, very possibly, real wholesome meals.

2. Tell the person you value them, no matter what

If something needs to die, it is usually the long-held fantasy that the person’s worth is identical to their usefulness and that their usefulness must be proved again and again every morning. 

I’ve observed that people who claim they are worthless often harbour deep anger. For instance, they may be furious at a culture that overworks employees and then offers token “wellness” programmes. Furious at the spouse who sees their collapse chiefly as an inconvenience to the household schedule. Furious at the parent who taught them to be dependable above all else.

If such thoughts percolate up, stay calm. People suffering from burnout have often suppressed this anger for too long, thinking that it would drive people away. Massive anger is best dealt with in the protected space of psychotherapy, but until such time, acknowledge that the person has a right to express themselves and that their emotions are valid. 

3. Show empathy for what was lost 

Burnout often involves unspoken grief. The person had certain expectations, which didn’t pan out. Perhaps they’ve just realised that the promised reward for decades of sacrifice was always just the opportunity to sacrifice more efficiently next quarter. 

The person might be mourning a self-image as someone who was once a star performer and even indispensable. Maybe they thought that performance, sustained at a sufficient cost for sufficient time, would eventually produce safety. They may mourn the lost time, but especially the story that made the sacrifice feel sensical.

4. In time, support a return to agency and desires 

This is the most delicate work, and it cannot be rushed. “Find your passion” belongs in the same category as “Just be yourself”, and sentences along the lines of “Everything happens for a reason” may gesture at comfort but deliver none. Desire does not return on command. It may appear first as preference or a flicker of curiosity. It may even look like irritation: “I don’t want to go to that dinner.” It’s very positive when this happens.  

Then the person might say, “I miss playing music.” That’s an improvement. Same for “I hate my job.” While hatred is never the end goal, it means stepping away from apathy and numbness. The person who hates something may, in time, find they can love something too. Don’t push, don’t suggest; just support. 

A free existence

The ironic truth is that many burnt-out people don’t need to become more balanced. They need to become more disobedient. I’m referring to disobedience to old rules and psychological slavery. They need to disappoint the internal committee squatting in their mind. They need to stop submitting every desire to that inner bureaucrat who has never approved an expense claim for pleasure without wincing.

They need to experience the radical scandal of being (at will): tired, limited, needy, bored, playful, sometimes useless and occasionally delighted – just because they exist and that they are enough.