Mood and Burnout (Pt. 2): Manage Overwhelm by Building Capacity
By Shelley Simon, RN, DC, MPH, EdD
We hear the language all the time: "I'm burned out." People say this when they're working long hours, in the midst of a seemingly never-ending project, sandwiched between caring for teenagers and elderly parents simultaneously; or – most often – when referring to their careers in general.Based on my years of work coaching chiropractors, I've come to the conclusion that many are indeed in various stages of burnout, and the problem has become endemic. I've further concluded that burnout is usually a direct result of being in a chronic state of overwhelm. That's language we also hear frequently: "I'm overwhelmed ... there are not enough hours in the day ... I'll never get caught up."
It's easy to confuse burnout with overwhelm, but there are differences between the two. Burnout is when you think there isn't much left to do except keep putting one foot in front of the other. It's when you feel like the best you can do is keep your head down and survive. It's when you feel disengaged, detached, flat and pessimistic about the future. Clearly, this is not a great place to be, and no amount of working longer or harder, or focusing on what you find dissatisfying, will solve the problem.
Overwhelm is when you feel like information, requests and tasks that demand your attention fly at you from every direction and with no end in sight; when your "To-Do" list just seems to get longer no matter how much you accomplish; and when you find yourself unable to cope with even the smallest request for your time or energy.
If you frequently or chronically feel overwhelmed, you're not alone. It used to be that Las Vegas was "the city that never sleeps." Today, that saying can be applied across the globe. The Digital Age in which we are steeped makes night and day interchangeable, work and home overlap, and our minds never have a chance to slow down because we are almost always plugged in to some source of information (only a small part of which actually demands our attention, but we feel the "need to know," anyway).
Assess First, Manage Second
The first step in managing overwhelm is recognizing it for what it is. Overwhelm is in part the reality of our fast-paced society and in part a result of choices and commitments you have made in terms of all you have on your plate. It's also the story you continually tell yourself about how overwhelmed you are.
Part of that story may include the idea that being in a constant state of doing is a badge of honor; that if you're not always behind the eight ball, then you must be missing out on something important; and that you are only as successful as your level of hyperactivity. Once you come to terms with the fact that none of this is true, you can objectively assess your situation by considering these questions:
Is the overwhelm primarily internal? Overwhelm is often rooted in the stories we tell ourselves. Are you truly on overload with all you have to do, or is your feeling of overwhelm mostly a result of thinking this is the case and verbalizing how overwhelmed you are without taking steps to address the situation, such as reviewing and reorganizing your priorities? Is it mainly your mood that's making you feel overwhelmed? Feeling chronically depressed, anxious, resentful or angry can both contribute to and stem from our feelings of overwhelm.
How are you really spending your time? We hear that "there aren't enough hours in the day" from people who, when pressed, admit to sitting in front of the television for hours each evening or somehow finding two or three hours a day, either at home or at work, keeping up with Facebook posts.
Take a long, hard look at where your hours really go by keeping a log of your activities for a couple of weeks. Then consider how shifting a few habits might help alleviate overwhelm. Chiropractors who experience the greatest success in their practices tend to be the ones who have a handle on time management.
How organized are you? Some people think the ability to be organized is a trait assigned at birth, like eye color, and that it can't be changed. The reality is that often all it takes to gain control over one's time and environment is paying closer attention to detail, being slightly more disciplined, clearing out unnecessary clutter, and learning basic skills – such as how to better use a computer, how to tame the paper monster that your home and office desks can become if ignored for too long, and how to manage personal finances.
Another part of the assessment process is to consider the view you take when looking at your state of overwhelm. If you have only a close-up view, you likely see everything on your plate as having equal priority. It's as if every task you have to do is haphazardly pinned to a wall in front of you and you can't see any farther than the wall. The paper that needs to be filed feels just as important as addressing the fact that you need to hire a new office manager.
If, however, you pan back and take too long a view of your situation, you won't be able to see the details on the wall and risk slipping into denial about the fact that large chunks of your life are out of control. The ideal is to zoom to a mid-range view so you can see the big picture and the details, and put both into perspective. Easier said than done, but by focusing in a realistic manner, you're one step closer to taking charge of your time, your environment, your practice and your life.
Building Capacity: 10 Strategies
Once you've assessed where you are in terms of overwhelm, you can take steps to turn the situation around by building your capacity to cope and manage. In doing so, you'll become more effective in dealing with the many moving parts of your life, and better able to focus your attention on achieving long-term professional success. Here are 10 strategies to consider, any or all of which will help alleviate feelings of overwhelm.
1. Manage your health. Take the advice you give your patients and apply it to yourself. You know better than anyone that when you take care of yourself with proper nutrition and regular exercise, you are healthier, vital and more resilient. In turn, you are better able to perform on every level – physically, socially, professionally and emotionally. If you are unwilling to take the steps necessary to tend to your most basic needs, then you're not serious about moving beyond overwhelm.
2. Manage your moods. Pay attention to how you respond, internally with self-talk and externally with others, when you're asked to do "one more thing." If you find you are frequently critical, short-tempered or resentful, work on managing your moods. I wrote about mood management in the Aug. 15, 2013 issue of this publication and encourage you to go back and read it again if you frequently find yourself feeling anxious, irritated, angry or hopeless. (It's available online if you've already read and recycled that issue.)
3. Slow down. This may sound like bad advice when you are overwhelmed and faced with more than you can possibly accomplish in a day, but slowing down and working on one task at time will actually increase your capacity to be productive and get more done. When you have a large project that requires your attention, don't view it as one big job. Instead, break it down into steps and approach it piece by piece. Celebrate completing each step and then move on to the next one. Experiment with working differently, keeping in mind that doing more of the same obviously hasn't been working if you are in a chronic state of overwhelm.
4. Recognize your limits. As a finite human being, like it or not, you have the same 24 hours in each day as everyone else. There is only so much that can be accomplished, no matter how efficient you become. It's OK to tell yourself and others certain tasks simply won't get done today, and maybe not tomorrow, and maybe not ever.
When overwhelm morphs into burnout, it's frequently because we ignore our personal limitations. You can easily slip into a state of poor work / life balance if you constantly take on more and more at the office and leave little time for home, family, friends, self-care and hobbies. If you find yourself thinking about work when you're at home and vice-versa, you may have stretched yourself beyond your own physical and emotional limits.
5. Respond more thoughtfully to requests. You are likely bombarded with multiple requests each day – from staff, from patients, from friends and family. When anyone asks you to do anything – see them after hours, give them a pay increase, attend a fund-raising event, coach Little League, fly across the country for a family reunion, or stop on the way home to pick up dinner – you have four choices in terms of responding:
A: Sure, I'll pick up dinner on the way home (Yes); B: Sorry, I can't coach Little League this year (No); C: I won't be able to attend the fund-raising event you have planned, but I can make a financial contribution (Counter-offer); or D: I'll consider your request for a raise and let you know my answer by next Friday. (Committing to commit at a future time).
Chiropractors who find themselves in a state of chronic overwhelm are often the ones who have fallen into the habit of choosing A – an immediate yes – as their default response to every request. Because this is often an insincere yes, it can result in broken promises when follow-through is lacking. This, in turn, leads to even greater feelings of being overcommitted, overburdened and overwhelmed.
6. Take it off the list. If you regularly move items on your To-Do list from day to day or week to week, perhaps they're not that critical after all. What's genuinely important tends to get accomplished. If you've had a task on your list for several weeks running and it's still not done, maybe it doesn't need your attention at all. It the task or project is something that really does need to be addressed, consider whether it can be deferred until a later time. Remember, everything is not a front-burner issue, although when you are in overwhelm mode it probably feels that way.
7. Delegate. Over the next few weeks, observe yourself as you go about your days – particularly at the office – and identify things you are doing that you could and should delegate to a staff member. If you're thinking as you read this that you don't have employees competent enough to handle what you would like to delegate, then you're going to need to take a hard look at your team and make some changes.
8. Improve processes. This is a longer-term fix to chronic overwhelm, but putting more efficient and effective policies, procedures and processes into place – ones that will ultimately save you time – is worth the effort. This falls under the heading of "working on the practice, not just in the practice." It is critical to approach your practice in a strategic manner by setting aside time periodically for reviewing, planning and improving. Consider investing in a one- or two-day staff retreat to focus on ways you and your entire team can make your practice more effective and, as a result, more enjoyable and profitable.
9. Engage the pros. There are countless professionals in a variety of disciplines who have the ability to help you reduce overwhelm. Is your lack of computer skills holding you back from being more efficient? Hire a tech tutor. Is your physical space in danger of being declared a federal disaster area? Hire a professional organizer. And don't overlook the value of investing in professional coaching – someone who can help you gain clarity, reorder priorities, set goals, and attain the practice success you desire and deserve.
10. Take time for renewal. I've saved this for last, but it may well be the most important piece of advice contained in this article. Burning the candle at both ends and not taking time to occasionally slow down and reflect is part of what gets chiropractors to the point of overwhelm to begin with. Build into your schedule the necessary time – an hour or two once a week, a day each month, or a week-long personal retreat once a year – to focus on emotional, spiritual, physical and professional renewal. If the thought of investing in yourself this way makes you feel anxious, then that's all the more reason to do it. And remember that carving out specific time to focus on renewal can include closing your office door to rest for five minutes, taking a walk around the block to clear your head, or simply pausing to take three or four deep breaths.
Learn to Manage Your Load
The potential for feeling overwhelmed is not going to go away. Demands on your time, talent and energy will at best stay steady and, if you are in a practice-building mode, will likely increase. Think about how you can produce more value, not just more effort. Always remember that doing more of the same will not solve the problem. Focus your attention at the mid-range, where you are able to pay attention to detail without losing sight of the larger picture. Manage your work / life balance and practice proper self-care.
Lena Horne said, "It's not the load that breaks you down; it's the way you carry it." If you're not carrying your load in a way that's working for you, consider the possibility of life coaching in addition to or instead of practice-management coaching. Investing in yourself may be the answer to managing overwhelm now before it develops into a full-blown case of career burnout.
Click here for previous articles by Shelley Simon, RN, DC, MPH, EdD.